Abstract:
The aim of this study was to evaluate the long-term results and to evaluate the validity of the treatment algorithm that can be safely applied in dfrontal sinus fractures. All patients were evaluated in terms of late-term contour deformity and further craniometric analysis for measurement of maximum amount of displacement, fracture surface area (mm2) and the maximum angulation of the fracture (degree) were done. 125 patients (101 male, 24 female) with frontal sinus fractures with an average age of 22.4 years (range,17-66 years) were reviewed. All patients with isolated anterior table fractures without displacement were followed up on conservative basis. 33 patients with anterior table fractures with displacement and 39 patients with anterior and posterior table fractures were also followed on conservative basis without surgical intervention. The cut-off value of the maximum amount of displacement was confirmed to be 4.5 mm in prediction of late-term contour deformities (p < 0.001). The maximum amount of displacement was decreased by an average of 1.8 mm at late-term. Apart from the standard protocols, within the limitations of the study it seems that isolated anterior table fractures with a maximum amount of displacement of less than 4.5 mm can be treated conservatively without leading to contour deformities. CSF leakage in the acute setting might not always require cranialization and this may spontaneously resolve within 10 days. Cranialization should be considered whenever CSF leakage lasts longer than 10 days.
摘要:
这项研究的目的是评估长期结果,并评估可安全应用于额窦骨折的治疗算法的有效性。所有患者均接受了晚期轮廓畸形的评估,并进一步进行了颅骨测量分析,以测量最大位移量,断裂表面积(mm2)和断裂的最大角度(度)。125名患者(101名男性,24名女性),额窦骨折,平均年龄22.4岁(范围,17-66年)进行了回顾。所有孤立性前台骨折无移位患者均在保守基础上进行随访。在保守的基础上,对33例有移位的前台骨折患者和39例前台和后台骨折患者也进行了随访,无需手术干预。在预测晚期轮廓畸形时,最大位移量的截止值为4.5mm(p<0.001)。后期最大位移量平均减少1.8mm。除了标准协议,在本研究的限制范围内,最大位移量小于4.5mm的孤立前台骨折似乎可以保守治疗,而不会导致轮廓畸形。急性背景下的CSF泄漏可能并不总是需要头颅,并且可能在10天内自发解决。只要脑脊液渗漏持续超过10天,就应考虑颅骨化。