Aesthetic treatment of frontal sinus fractures and their complications

Kwang Seog Kim; Jae Ha Hwang

doi:10.5124/jkma.2018.61.12.732

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Kim and Hwang: Aesthetic treatment of frontal sinus fractures and their complications

Focused Issue of this Month

J Korean Med Assoc 2018;61(12):732-739.

Published online: 17 December 2018

DOI: https://doi.org/10.5124/jkma.2018.61.12.732

Aesthetic treatment of frontal sinus fractures and their complications

Kwang Seog Kim, MD, Jae Ha Hwang, MD

Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea

Corresponding author: Kwang Seog Kim E-mail: pskim@chonnam.ac.kr

Received 3 December 2018 Accepted 3 December 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The frontal sinus is a functionally important structure. It serves as a cushioning buffer to protect the brain in cases of facial trauma. Fractures of the frontal sinus can lead to aesthetic problems by causing a visible depression in the center of the forehead. The goals of frontal sinus fracture treatment have been to protect intracranial structures and to prevent early and late complications, even with invasive methods. Recently, however, the goals have shifted to preservation of nasofrontal outflow tract function through close observation and the utilization of endoscopic procedures. Excellent cosmetic results can be achieved through minimally invasive surgery. This shift in goals took place due to the ease of diagnosis and treatment of early and late complications. Therefore, patients with a frontal sinus fracture should be followed up continuously to ensure that complications are detected promptly. Herein, the authors describe the methods and current trends of frontal sinus fracture treatment.

Keywords: Frontal sinus, Fractures, Complications, Aesthetic, Therapy

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Figure 1.

Sagittal view showing a well-pneumatized frontal sinus in a 21-year-old man.

Figure 2.

Materials for internal fixation. (A) Titanium plates and screws. (B) Absorbable mesh plate and screws. Informed consent was obtained from the patient.

Figure 3.

A 16-year-old boy with a right frontal sinus fracture due to a sports injury. (A,B) Preoperative computed tomograms demonstrating a right anterior table frontal sinus fracture. (C,D) Postoperative computed tomograms demonstrating a well-reconstructed anterior table of the frontal sinus in the proper position.

Figure 4.

Algorithm for the treatment of frontal sinus fractures

Figure 5.

A 64-year-old man with a large frontal mucocele occurring 30 years after frontal sinus fracture. (A-C) Preoperative computed tomograms. (D-F) Computed tomograms after endoscopic intranasal frontal sinusotomy.

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