Unilateral Cranialization as an Approach for Posterior Table Frontal Sinus Fractures.

Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 9010410 Publication Model: Print Cited Medium: Internet ISSN: 1536-3732 (Electronic) Linking ISSN: 10492275 NLM ISO Abbreviation: J Craniofac Surg

Publication: <2014-> : Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Burlington, Ont. : B.C. Decker, c1990-

Fractures, Comminuted/*surgery ; Frontal Sinus/*surgery ; Skull Fractures/*surgery; Facial Injuries/surgery ; Fractures, Comminuted/diagnostic imaging ; Frontal Sinus/diagnostic imaging ; Humans ; Male ; Skull Fractures/diagnostic imaging ; Young Adult

Management of posterior table fractures has seen a conservative shift in recent years. Patients who present with CSF leak may be safely monitored, while cranialization is reserved for patients with severe comminuted or displaced posterior table fractures. We report the case of a 20-year-old patient with a comminuted, displaced posterior table fracture that was missing a central segment and was associated with dural injury. The septum and contralateral sinus were unaffected, thus warranting unilateral cranialization. This is a reported case of hemicranialization, which falls on the spectrum of a conservative approach. At 12 months post-op, the patient has not experienced any complications historically associated with cranialization including persistent CSF leak, meningitis, wound infection, alopecia or facial nerve injury at the site of surgery.

Metzinger SE, Metzinger RC. Complications of frontal sinus fractures. Craniomaxillofac Trauma Reconstr 2009; 2:27–34.
Sakas DE, Beale J, Ameen AA, et al. Compound anterior cranial base fractures: classification using computerized tomography scanning as a basis for selection of patients for dural repair. J Neurosurg 1998; 88:471–477.
Schultz K, Braun TL, Truong TA. Frontal sinus fractures. Sem Plast Surg 2017; 31:80–84.
Rohrich RJ, Hollier LH. Management of frontal sinus fractures: changing concepts. Clin Plast Surg 1992; 19:219–232.
Choi M, Li Y, Shapiro SA, et al. A 10-year review of frontal sinus fractures: clinical outcomes of conservative management of posterior table fractures. Plast Reconstr Surg 2012; 130:399–406.
Kim IA, Boahene KD, Byrne PJ. Trauma in facial plastic surgery: frontal sinus fractures. Facial Plast Surg Clin North Am 2016; 25:503–511.
Chegini S, Gallighan N, McLeod N, et al. Outcomes of treatment of fractures of the frontal sinus: review from a tertiary multispecialty craniofacial trauma service. Br J Oral Maxillofac Surg 2016; 54:801–805.
Rodriguez ED, Stanwix MG, Nam AJ, et al. Twenty-six-year experience treating frontal sinus fractures: a novel algorithm based on anatomical fracture pattern and failure of conventional techniques. Plast Reconstr Surg 2008; 122:1850–1866.
Weathers WM, Wolfswinkel EM, Hatef DA, et al. Frontal sinus fractures: a conservative shift. Craniomaxillofac Trauma Reconstr 2013; 6:155–160.
Pollock RA, Hill JL, Davenport DL, et al. Cranialization in a cohort of 154 consecutive patients with frontal sinus fractures (1987-2007). Review and update of a compelling procedure in the selected patient. Ann Plast Surg 2013; 71:54–59.
Weitman E, Shilo D, Emodi O, et al. Solitary frontal sinus fractures compared to multiple facial fractures, energy impact dependency. J Craniofac Surg 2017; 28:1812–1815.
Maturo SC, Weitzel EK, Cowhart J, Brennan J. Isolated posterior table frontal sinus fractures do not form mucoceles in a goat model. Otolaryngol Head Neck Surg 2008; 139:688–694.
Kühnel TS, Reichert TE. Trauma of the midface. GMS Curr Top Otorhinolaryngol Head Neck Surg 2015; 14:Doc06.
Weber R, Hosemann W, Draf W, et al. Endonasal frontal sinus surgery with permanent implantation of a place holder. Laryngo-Rhino-Otologie 1997; 76:728–734.

Date Created: 20200115 Date Completed: 20200911 Latest Revision: 20210209

20240829

10.1097/SCS.0000000000006165

31934977