전두동 골절 양상에 따른 치료 (Treatment of Frontal Sinus Fractures According to Fracture Patterns)

서지정보

· 발행기관 : 대한두개안면성형외과학회
· 수록지 정보 : Archives of Craniofacial Surgery / 10권 / 2호 / 91 ~ 96페이지
· 저자명 : 하주호, 김용하, 남현재, 김태곤, 이준호

초록

Purpose: Frontal sinus fractures are relatively less common
than other facial bone fractures. They are commonly
concomitant with other facial bone fractures. They can
cause severe complications but the optimal treatment of
frontal sinus fractures remains controversial. Currently,
many principles of treatment were introduced variously. The
authors present valid and simplified protocols of treatment
for frontal sinus fractures based on fracture pattern,
nasofrontal duct injury, and complications.
Methods: A retrospective chart review was performed on
36 cases of frontal sinus fractures between January, 2004
and January, 2009. The average age of patients was 33.7
years. Fracture patterns were classified by displacement of
anterior and posterior wall, comminution, nasofrontal duct
injury. These fractures were classified in 4 groups: Ⅰ.
anterior wall linear fractures; Ⅱ. anterior wall displaced
fractures; Ⅲ. anterior wall displaced and posterior wall linear
fractures; Ⅳ. anterior wall and posterior wall displaced
fractures. Also, assessment of nasofrontal duct injury was
conducted with preoperative coronal section computed
tomographic scan and intraoperative findings. Patients were
treated with various procedures including open reduction
and internal fixation, obliteration, galeal frontalis flap and
cranialization.
Results: 12 patients are group Ⅰ (33.3 percent), 14 patient
were group Ⅱ (38.8 percent), group Ⅲ, Ⅳ were 5 each (13.9
percent). Frontal sinus fractures were commonly associated
with zygomatic fractures (21.8 percent). 9 patients had
nasofrontal duct injury. The complication rate was 25
percent (9 patients), including hypoesthesia, slight forehead
irregularity, transient cerebrospinal fluid leakage.
Conclusion: The critical element of successful frontal
sinus fracture repair is precise diagnosis of the fracture
pattern and nasofrontal duct injury. The main goal of
management is the restoration of the sinus function and
aesthetic preservation.

영어초록

Purpose: Frontal sinus fractures are relatively less common
than other facial bone fractures. They are commonly
concomitant with other facial bone fractures. They can
cause severe complications but the optimal treatment of
frontal sinus fractures remains controversial. Currently,
many principles of treatment were introduced variously. The
authors present valid and simplified protocols of treatment
for frontal sinus fractures based on fracture pattern,
nasofrontal duct injury, and complications.
Methods: A retrospective chart review was performed on
36 cases of frontal sinus fractures between January, 2004
and January, 2009. The average age of patients was 33.7
years. Fracture patterns were classified by displacement of
anterior and posterior wall, comminution, nasofrontal duct
injury. These fractures were classified in 4 groups: Ⅰ.
anterior wall linear fractures; Ⅱ. anterior wall displaced
fractures; Ⅲ. anterior wall displaced and posterior wall linear
fractures; Ⅳ. anterior wall and posterior wall displaced
fractures. Also, assessment of nasofrontal duct injury was
conducted with preoperative coronal section computed
tomographic scan and intraoperative findings. Patients were
treated with various procedures including open reduction
and internal fixation, obliteration, galeal frontalis flap and
cranialization.
Results: 12 patients are group Ⅰ (33.3 percent), 14 patient
were group Ⅱ (38.8 percent), group Ⅲ, Ⅳ were 5 each (13.9
percent). Frontal sinus fractures were commonly associated
with zygomatic fractures (21.8 percent). 9 patients had
nasofrontal duct injury. The complication rate was 25
percent (9 patients), including hypoesthesia, slight forehead
irregularity, transient cerebrospinal fluid leakage.
Conclusion: The critical element of successful frontal
sinus fracture repair is precise diagnosis of the fracture
pattern and nasofrontal duct injury. The main goal of
management is the restoration of the sinus function and
aesthetic preservation.

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