1
|
Catalfamo LM, Scozzaro C, De Rinaldis D, Romeo C, Cicchiello S, Nava C, Squillacioti A, De Ponte FS. The C-S Approach for The Management of Median or Paramedian Frontal Sinus Lesion. Indian J Otolaryngol Head Neck Surg 2022; 74:4598-4602. [PMID: 36742757 PMCID: PMC9895234 DOI: 10.1007/s12070-021-02896-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 09/26/2021] [Indexed: 02/07/2023] Open
Abstract
The frontal sinus is one the most complex of the paranasal sinuses, its proximity to the cranial vault and the orbit cause that frontal sinus pathologies can progress to involve these structures and lead to significant morbidity, or even death. Surgical management of the frontal sinus is technically challenging, the most commonly used surgical approaches are coronal, butterfly, gullwing and suprabrow. The purpose of this article is to propose the C-S approach, an interesting alternative to the gullwing approach for the managing of median and paramedian frontal sinus lesions or isolated displaced fractures of the anterior wall. The main advantage of this technique is represented by the fact that it follows the new tension lines described in the literature, a curved vertical line that follows the glabellar frown.
Collapse
Affiliation(s)
- Luciano Maria Catalfamo
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Calogero Scozzaro
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
- AOU Policlinico “G. Martino”, Via Consolare Valeria, 1, 98125 Messina, Italy
| | - Danilo De Rinaldis
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Chiara Romeo
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Samuele Cicchiello
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Carla Nava
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
| | - Antonella Squillacioti
- Division of Maxillofacial Surgery, BIOMORF Department, University of Messina, Messina, Italy
| | | |
Collapse
|
2
|
Langlie J, Kim M, Thaller SR. Frontal Sinus Fractures: A Review on Etiology and Management Emphasizing Minimally Invasive and Endoscopic Techniques. J Craniofac Surg 2021; 32:1246-50. [PMID: 33770048 DOI: 10.1097/SCS.0000000000007623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT In spite of a long and tortuous history of the acute management of frontal sinus fractures, current optimal management remains steeped in controversy. These fractures are frequently produced by excessive forces and are often accompanied with other injuries. However, disruption of the nasofrontal duct persists as essential to maintain proper sinus function and should guide current management. Although there has never been any distinct procedure defining optimal outcomes, proper treatment is contingent on precise diagnosis culled from a complete history, physical examination, and imaging studies. This is further augmented by the surgeon's intraoperative findings. Reconstruction will ultimately rest on the degree of disruption of the anterior and posterior sinus walls, as well as the status and function of the nasofrontal ducts. For these reasons, current management continues to be challenging and evolving. Thus, this review will discuss the etiology and clinical presentation of frontal sinus fractures, the current complications arising in the subject, and the evolution of treatment options towards a more conservative and endoscopic approach to care.
Collapse
|
3
|
Al-Shami H, Alnemare AK, Mahfoz TB, Salah AM. Traumatic Frontal Sinus Fractures Management: Experience from High-Trauma Centre. Korean J Neurotrauma 2021; 17:15-24. [PMID: 33981639 PMCID: PMC8093022 DOI: 10.13004/kjnt.2021.17.e3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 08/10/2020] [Accepted: 11/18/2020] [Indexed: 11/15/2022] Open
Abstract
Objective Analysis of our traumatic brain injury data, reviewing current literatures and assessing planning valuable decision making in frontal sinus fracture for young neurosurgeons. Methods Hospital data base for head trauma was retrieved after board permission for retrospective analysis of cases admitted from 2010-2020. Patients with frontal sinus fractures and head trauma were identified according to a flow chart. Variables of the study included patients' demographics, mechanism of injury, incidence of cerebrospinal fluid (CSF) leakage, types of associated injuries, imaging findings and operative techniques. Results Three-hundred eighty two patients were eligible to be screened in our study and represented the sample size under investigations in the following sections, 206 (53.9%) of patients were treated conservatively while 176 patients (46.1%) were identified as having an indication for surgical intervention. Eighty-four percent of patients were males. The mean age was 36.2±9.4 years (14-86 years). Depressed skull fracture was commonly associated injury (17.61%). Leakage of CSF was found in 32.95% of patients. Conclusion Frontal sinus fracture is not an easy scenario. It harbors many proportions and deliver many varieties in which, deep understanding of anatomy, naso-frontal outflow tract status, CSF leakage and neurological injury are of important points in decision. Our institutional algorithm provide rapid, accessible and applicable treatment protocol for resident and young neurosurgeons which minimizes consultations of other specialties.
Collapse
Affiliation(s)
- Hieder Al-Shami
- Department of Neurosurgery, Al-Ahly Bank Hospital, Cairo, Egypt
| | - Ahmad K. Alnemare
- Department of Otolaryngology, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Turki Bin Mahfoz
- Department of Otolaryngology, Faculty of Medicine, Al Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia
| | - Ahmed M. Salah
- Department of Neurosurgery, Faculty of Medicine, Kasr Al-Ainy Medical College, Cairo, Egypt
| |
Collapse
|
4
|
Chu YY, Lim E, Liao HT. Ipsilateral transnasal medial canthopexy to correct secondary telecanthus after naso-orbito-ethmoid fracture. J Plast Reconstr Aesthet Surg 2020; 73:934-41. [PMID: 32151558 DOI: 10.1016/j.bjps.2020.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/29/2019] [Accepted: 01/05/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Telecanthus results from medial canthal tendon (MCT) disruption, which can result from traumatic naso-orbito-ethmoid (NOE) fractures. Several methods, using different anchoring materials, incision approaches, or fixation positions, have been proposed for MCT reconstruction. Herein, we report our experience in treating MCT disruption using ipsilateral transnasal medial canthopexy with a Y-V approach. PATIENTS AND METHODS Between 2008 and 2017, seven patients with traumatic NOE fractures underwent ipsilateral transnasal MCT fixation with Y-V epicanthoplasty. The length ratio, defined as the length of the affected side divided by that of the normal side, was calculated preoperatively and postoperatively. A modified Y-V epicanthoplasty incision was made, after first marking the site in the apex of the caruncular fornix. The nasal wall was exposed and the MCT was accessed carefully. Bulky MCT tissue was trimmed. The lacrimal bone was ground using a bur, creating a concave shape to reposition the MCT, and two holes were drilled into the ipsilateral lacrimal fossa and frontomaxillary process. The MCT was fixed to the frontomaxillary process using no. 2 transnasal wire, which was secured by a 6-mm screw. Finally, the Y-V epicanthoplasty was repaired using 5.0 nylon. RESULTS The preoperative length ratio (mean±standard deviation: 83.3%±6.0%; range: 73.7%-92.0%) was significantly lower than the postoperative length ratio (mean±standard deviation: 99.4%±0.6%; range: 98.5%-100%) (p<0.05). No major complications were observed, with an average of 13 months of follow-up. CONCLUSIONS Ipsilateral transnasal wiring fixation with Y-V epicanthoplasty is a useful and adequate method for MCT reconstruction after NOE fractures, without remarkable complications.
Collapse
|
5
|
Abstract
PURPOSE OF REVIEW Frontal sinus fracture management is evolving. This article will highlight recent literature and provide an evidence-based algorithm in the contemporary management of frontal sinus fractures. RECENT FINDINGS The role of transnasal endoscopic treatment of frontal sinus fractures has expanded to include fracture reduction and posterior table reconstruction. Evidence continues to support the safety of nonoperative management in select frontal sinus outflow tract fractures. SUMMARY The management of frontal sinus fractures with frontal sinus outflow tract injury continues to evolve with a trend toward observation and minimally invasive approaches. Restoration of the frontal sinus outflow tracts with transnasal endoscopic techniques is being used increasingly in the acute and delayed setting. For severe fractures, the role of conservative treatment paradigms requires further research.
Collapse
|
6
|
Nguyen D, Hakimi M, Sinha SR, Martin M. Upper Eyelid Approach for the Reconstruction of Isolated Fractures of the Anterior Wall of the Frontal Sinus. J Craniofac Surg 2018; 29:1903-1905. [PMID: 30234709 DOI: 10.1097/scs.0000000000005004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The management of frontal sinus fractures can vary widely depending on involvement of the anterior wall, the posterior wall, and the frontonasal duct. The main morbidity associated with isolated anterior wall fractures is an aesthetic deformity. Treatment includes coronal, endoscopic, and transcutaneous approaches. However, each has reported limitations and associated risks of iatrogenic injuries. In this paper, the authors discuss a novel approach through the upper eyelid crease and examine 4 cases where it is utilized for anterior frontal sinus wall, superior orbital rim, and orbital roof fracture repair.
Collapse
Affiliation(s)
- David Nguyen
- Loma Linda University, Loma Linda.,Riverside University Health System, Moreno Valley
| | - Michael Hakimi
- Loma Linda University, Loma Linda.,Riverside University Health System, Moreno Valley
| | | | - Mark Martin
- Loma Linda University, Loma Linda.,Riverside University Health System, Moreno Valley
| |
Collapse
|
7
|
Bourry M, Oliver C, Maalouf J, Corre P, Bertin H. Surgical approach of isolated fracture of the anterior wall of the frontal sinus: The upper eyelid incision. J Stomatol Oral Maxillofac Surg 2019; 120:240-3. [PMID: 30496847 DOI: 10.1016/j.jormas.2018.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/31/2018] [Accepted: 11/19/2018] [Indexed: 11/20/2022]
Abstract
Fractures of the frontal sinus are classified according to the topography (anterior wall, posterior wall or both), the displacement, and the presence of associated lesions (wound, nasofrontal duct injury, rhinorrhea). Isolated fractures of the anterior wall require surgical management, if the displacement is over 4 mm, to restore the forehead symmetry, to maintain the sinus ventilation and to avoid long-term complications (sinusitis, mucocele, meningitis…). Coronal incision is commonly performed but less invasive techniques are more and more used. We describe a technique of reduction and fixation of isolated anterior wall fractures by upper eyelid incision, allowing a good exposure of the lower portion of the frontal sinus, with a limited scar.
Collapse
|
8
|
Chouake RJ, Miles BA. Current opinion in otolaryngology and head and neck surgery: frontal sinus fractures. Curr Opin Otolaryngol Head Neck Surg 2017; 25:326-31. [PMID: 28504985 DOI: 10.1097/MOO.0000000000000369] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW The purpose of this manuscript is to review the current literature regarding the management of frontal sinus fractures and offer the authors opinion on the current management of these traumatic injuries. We evaluate recently proposed management algorithms as well as novel surgical approaches reported within the last few years. RECENT FINDINGS Patient selection for sinus sparing treatment modalities is balanced between fracture severity, involved structures, and reliable patient surveillance. Minimally invasive, aesthetically favorable approaches grow in diversity for anterior table fractures. For fractures of the posterior sinus wall and nasofrontal outflow tract, the literature focuses on sinus sparing surgery, as well as better defining the patients in which obliteration and/or cranialization is appropriate. SUMMARY Lack of large patient cohorts and follow-up limits generalizability of frontal sinus fracture research, and the ability to develop national guidelines of management. Evidence-based literature shows growing support for conservative management and sinus preservation. Improvements in frontal sinus fracture classification schemes, surgical technique, and patient selection direct this treatment paradigm shift.
Collapse
|
9
|
Abstract
The frontal bone serves a protective role, representing the transition between the facial skeleton and the cranium. Within its enclosure, the frontal sinus lies adjacent to many important intracranial structures, and injury to this region has severe complications if not properly managed. Historically, the goals of frontal sinus fracture management have been to best prevent intracranial complications with invasive procedures, but a recent shift favoring conservative management now aims to preserve the form and function of the frontal sinus and its outflow tract. With the advancement of endoscopic techniques and the development of new technologies, many alternatives to aggressive surgical management are available.
Collapse
Affiliation(s)
- Kelly Schultz
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Tara L Braun
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| | - Tuan A Truong
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
| |
Collapse
|