Bell et al proposed an algorithm for the management of a frontal sinus fracture that maximizes preservation when possible. The authors are from Oregon Health & Science University in Portland, Oregon.
Patient evaluation:
(1) displaced fracture of the frontal sinus
(2) frontonasal duct intact
(3) posterior table comminuted or displaced
(4) significant brain injury and/or dural embarrassment
Response to #1
Response to #2
Other Responses
Management
Yes
#3 and/or #4 Yes
A and B
#3 and #4 No
A
No
A and C
#3 Yes
D
#3 No
A and E
Management steps
(A) Repair anterior table.
(B) Cranialize.
(C) Obliterate sinus (typically with adipose tissue from the patient's abdomen)
(D) Observe and take nasal precautions (avoiding nose blowing, sneezing and the Valsalva maneuver).
(E) Repair naso-orbitoethmoid (NOE) component.
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Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Otolaryngology
ICD-10: ,
