Hybels R L, Newman M H
Laryngoscope. 1977 Feb;87(2):171-9. doi: 10.1288/00005537-197702000-00004.
Experiments using cats were performed to examine the natural history of posterior table fractures of the frontal sinus and the methods available for treatment. Elevation of depressed fractures and obliteration by either fat or osteoneogenesis and fibrosis were the modalities of treatment used. Comparisons were made with untreated controls. Fascia reinforcement of the dura and plugging of the nasofrontal duct were variables. The nasofrontal duct is critical in the natural history of these injuries. All fractures of the posterior table heal if drainage into the nose is maintained. Fractures which are elevated heal by bony union with associated mucosal and dural healing. Loose fragments of the posterior table heal if left in place. Mucoceles form if the nasofrontal duct is obstructed, if mucosa is inadequately removed during obliteration and, in some instances, where islands of mucosa are isolated by mucosal laceration. Viable adipose tissue in the sinus prevents significant ingrowth of mucosa from the nasofrontal duct. Growth of mucosa into fracture lines was not a problem. Both adipose transplants and intrasinus fascia reinforcement appeared to contribute to well defined posterior table healing.
进行了以猫为对象的实验，以研究额窦后板骨折的自然病程以及可用的治疗方法。治疗方式包括凹陷骨折的复位以及通过脂肪填充、骨生成和纤维化进行闭塞，并与未经治疗的对照组进行比较。硬脑膜的筋膜加固和鼻额管堵塞是可变因素。鼻额管在这些损伤的自然病程中至关重要。如果保持鼻腔引流，后板的所有骨折均可愈合。复位的骨折通过骨愈合以及相关的黏膜和硬脑膜愈合。后板的松散碎片如果留在原位也可愈合。如果鼻额管阻塞、在闭塞过程中黏膜清除不充分以及在某些情况下黏膜岛被黏膜撕裂隔离，则会形成黏液囊肿。窦内的存活脂肪组织可防止黏膜从鼻额管大量向内生长。黏膜长入骨折线不是问题。脂肪移植和窦内筋膜加固似乎都有助于后板实现明确的愈合。
