Background Frontal sinus fractures, particularly anterior sinus fractures, are relatively common
facial fractures. Many agree on the general principles of frontal fracture management;
however, the optimal methods of reduction are still controversial. In this article,
we suggest a simple reduction method using a subbrow incision as a treatment for isolated
anterior sinus fractures.
Methods Between March 2011 and March 2014, 13 patients with isolated frontal sinus fractures
were treated by open reduction and internal fixation through a subbrow incision. The
subbrow incision line was designed to be precisely at the lower margin of the brow
in order to obtain an inconspicuous scar. A periosteal incision was made at 3 mm above
the superior orbital rim. The fracture site of the frontal bone was reduced, and bone
fixation was performed using an absorbable plate and screws.
Results Contour deformities were completely restored in all patients, and all patients were
satisfied with the results. Scars were barely visible in the long-term follow-up.
No complications related to the procedure, such as infection, uncontrolled sinus bleeding,
hematoma, paresthesia, mucocele, or posterior wall and brain injury were observed.
Conclusions The subbrow approach allowed for an accurate reduction and internal fixation of
the fractures in the anterior table of the frontal sinus by providing a direct visualization
of the fracture. Considering the surgical success of the reduction and the rigid fixation,
patient satisfaction, and aesthetic problems, this transcutaneous approach through
a subbrow incision is concluded to be superior to the other reduction techniques used
in the case of an anterior table frontal sinus fracture.
Keywords
Surgical procedures, minimally invasive - Fracture fixation, internal - Frontal sinus
