Abstract
Management of frontal sinus fractures is controversial with no universally accepted
treatment protocol. Goals of management are to correct aesthetic deformity, preserve
sinus function when it is deemed salvageable, prevent sequela related to the injury,
and minimize complications associated with intervention. Studies suggest that frontal
sinus injuries, including disruption of the nasofrontal outflow tract (NFOT), can
be managed nonoperatively in many cases. Advances in the utilization of endoscopic
techniques have led to an evolution in management that reduces the need for open procedures,
which have increased morbidity compared with endoscopic approaches. We employ a minimally
disruptive protocol that treats the majority of fractures nonoperatively with serial
clinical and radiographic examinations to assess for sinus aeration. Surgical intervention
is reserved for the most severely displaced and comminuted posterior table fractures
and unsalvageable NFOTs utilizing endoscopic approaches whenever possible.
Keywords
frontal sinus fractures - endoscopic - transorbital - navigation - cerebrospinal fluid
