Transcutaneous transfrontal approach through a small peri-eyebrow incision for the reduction of closed anterior table frontal sinus fractures

Abstract

Transcutaneous or endoscopic approaches are commonly used to reduce closed anterior table frontal sinus fractures. However, transcutaneous approaches cause serious skin sequelae, and endoscopic approaches have a steep learning curve. To resolve these problems, between 2001 and 2008, a transcutaneous transfrontal approach through a small peri-eyebrow skin incision was used in 17 male patients. Postoperative computed tomography scans showed adequate reduction of displaced bone fragments in all cases. No complications related to this procedure, such as uncontrollable sinus bleeding, infection and posterior table and brain injuries, were observed. Follow-ups ranged from 4 to 27 months, with an average of 14 months. Contour deformities were effectively restored and cosmetic results at incision sites were acceptable in all patients. The transcutaneous transfrontal approach through a small peri-eyebrow incision is a safe procedure that can be performed with minimal morbidity and offers good access and excellent aesthetic results. Based on the results obtained, the authors suggest that this method be considered the treatment of choice for the reduction of closed anterior table frontal sinus fractures.