Frontal sinus fractures: A review of 72 cases

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Abstract
A retrospective review is presented of 72 patients who sustained frontal sinus fractures (FSF) and were subsequently treated by the department of otolaryngology/head and neck surgery between the years of 1974 and 1986.Eighty‐four percent of FSF occurred in males and 71% were a result of motor vehicle accidents. Only 24% remained conscious at the time of trauma, and in only one third of the cases was there no other facial fracture. Seventy‐six percent of FSF involved both the anterior and posterior walls—a figure that possibly reflects the referral patterns to a hospital that is a major regional trauma center.Patients were treated with a variety of procedures including cranialization (42%), osteoplastic flap and fat obliteration (30%), open reduction and internal fixation of the anterior wall (20%), osteoplastic flap and sinus ablation (6%), and intersinus septectomy (1%).Some difficulty was encountered in documenting sustained follow‐up, which ranged from 2 months to 9 years, and averaged 22 months. Nine percent of patients died in the post‐trauma period. Minor complications were relatively common, but major complications occurred in only 10% of patients. Four patients (6%) suffered meningitis (although the portal of infection was not necessarily through the frontal sinus); one patient (1%) suffered severe pain over the sinus and forehead for at least 12 months after surgery; and a mucocele developed in four patients (6%).