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Minimally Disruptive Protocol Acceptable for Frontal Sinus Fx

Minimally Disruptive Protocol Acceptable for Frontal Sinus Fx
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FRIDAY, Feb. 3, 2017 (HealthDay News) — A minimally disruptive treatment protocol seems acceptable for frontal sinus fractures, according to a study published online Feb. 2 in JAMA Facial Plastic Surgery.

Sapna A. Patel, M.D., from the University of Washington in Seattle, and colleagues analyzed prospectively collected data from 2010 through 2015 for patients with frontal sinus fractures. Thirty-nine patients were treated under the minimally disruptive protocol, and 25 were included in the study (age 6 to 62 years). Twenty-two patients had clinical and radiographic follow-up.

The researchers found that five of the 22 patients underwent surgery for indications other than frontal sinus fracture: One underwent immediate surgical repair due to bilateral LeFort fracture and four underwent delayed surgery due to nasal polyp, scar revision, and concomitant LeFort fractures (one, one, and two patients, respectively). Two patients underwent frontal sinus repair after outpatient surveillance due to persistent cerebrospinal fluid leak and orbital roof fracture (one patient each). Twenty patients were treated nonoperatively, 19 of whom had spontaneous improvement in opacification and/or contour deformity. Improvement or resolution in both was reported by 12 patients. At the three-month follow-up, one patient had ongoing partial opacification and deformity, but was asymptomatic and had an esthetically acceptable bony contour.

“Frontal sinus fractures treated nonoperatively had a high rate of spontaneous ventilation and bony autoreduction with aesthetically acceptable frontal bone remodeling,” the authors write.

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