Certain clinical findings can help identify a trauma patient who should have a CT scan to evaluate the frontal sinuses.


Physical findings:

(1) forehead ecchymosis or hematoma

(2) forehead laceration

(3) bony step in the glabella or supraorbital ridge

(4) penetrating forehead injury



(1) zygoma

(2) nasal

(3) orbital roof or floor

(4) LeFort I, II or III

(5) mandibular


Ocular injuries:

(1) damage to the globe

(2) cranial nerve palsy or sensory loss involving the II, III, IV, V (frontal nerve), VI nerves

(3) subconjunctival ecchymosis

(4) retinal detachment

(5) diplopia on upward or downward gaze


Other findings:

(1) CSF rhinorrhea or otorrhea

(2) differences seen on transilluminating both frontal sinuses


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