Management of Frontal Sinus Fractures at a Level 1 Trauma Center: Retrospective Study and Review of the Literature

Kimberly Oslin; Meryam Shikara; Joshua Yoon; Pharibe Pope; Kelly Bridgham; Suneet Waghmarae; Andrea Hebert; Fan Liang; Kalpesh Vakharia; Natalie Justicz

doi:10.1177/19433875231155727

Management of Frontal Sinus Fractures at a Level 1 Trauma Center: Retrospective Study and Review of the Literature

Craniomaxillofac Trauma Reconstr. 2024 Mar;17(1):24-33. doi: 10.1177/19433875231155727. Epub 2023 Feb 9.

Authors

Kimberly Oslin¹, Meryam Shikara², Joshua Yoon³, Pharibe Pope¹, Kelly Bridgham¹, Suneet Waghmarae¹, Andrea Hebert^{1

2}, Fan Liang^{1

3}, Kalpesh Vakharia^{1

2}, Natalie Justicz^{1

2}

Affiliations

¹ University of Maryland School of Medicine, Baltimore, MD, USA.
² Department of Otorhinolaryngology - Head and Neck Surgery, University of Maryland Medical System, Baltimore, MD, USA.
³ Division of Plastic Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA.

PMID: 38371220
PMCID: PMC10874201 (available on 2025-03-01)
DOI: 10.1177/19433875231155727

Abstract

Study design: Case series.

Objective: This retrospective review of frontal sinus fractures aims to describe our current experience managing these fractures at an urban level I trauma center.

Methods: An institutional database of 2081 patients who presented with maxillofacial fractures on computed tomography face/sinus in 2019 was queried for all patients with traumatic frontal sinus fractures. Demographics, trauma-related history, management approach, and follow-up data were collected and analyzed.

Results: Sixty-three (7.3%) patients had at least one fracture involving the frontal sinus. The most common etiologies were assaults, falls, and motor vehicle accidents. Surgical repair was performed in 26.8% of patients with frontal sinus fractures, and the other 73.2% were observed. Fractures that were displaced, comminuted, obstructive of the frontal sinus outflow tract, or associated with a dural tear or cerebrospinal fluid leak were more likely to be operative.

Conclusions: The majority of frontal sinus fractures in this study were treated with observation. Despite advances in transnasal endoscopic approaches, many surgeons still rely on open approaches to repair frontal sinus fractures.

Keywords: facial trauma; frontal sinus; frontal sinus fracture; frontal sinus outflow tract; maxillofacial trauma.