背景:额窦损伤在面骨创伤中相对罕见。如果没有适当的治疗,会导致致命的颅内并发症,包括脑膜炎或脑脓肿,以及美学和功能后遗症。额窦损伤的处理仍然存在争议,报告了各种治疗方法和结果。本文介绍了临床特点,手术方法,17例因额窦损伤和相关并发症而接受手术的患者的结局。
方法:我们回顾性地纳入了2010年7月至2021年9月在康原国立大学医院接受额窦损伤及其相关并发症手术的17例患者。其中,六个人接受了简单的切开复位和前壁固定,八个人做了鼻窦闭塞,三人接受了头颅检查。两名接受鼻窦闭塞的患者因感染相关并发症死亡。接受颅骨治疗的患者报告经历了慢性头痛,并对前额的美学结果表示不满。除了这三个病人,其他患者均获得满意的美学和功能恢复。
结论:由于额窦损伤引起的各种并发症,通常需要积极的手术治疗;然而,几个因素,包括骨折类型,临床表现,相关的颅颌面损伤,和病史,在制定治疗方案时应予以考虑。对于严重受损的后壁骨折和有感染风险的患者,应积极考虑通过额窦开口进行手术治疗。
BACKGROUND: Frontal sinus injuries are relatively rare among facial bone traumas. Without proper treatment, they can lead to fatal intracranial complications, including meningitis or brain abscesses, as well as aesthetic and functional sequelae. The management of frontal sinus injuries remains controversial, with various treatment methods and outcomes being reported. This article describes the clinical characteristics, surgical methods, and outcomes among 17 patients who underwent surgery for frontal sinus injury and related complications.
METHODS: We retrospectively included 17 patients who underwent surgery for frontal sinus injury and its related complications at the Kangwon National University Hospital between July 2010 and September 2021. Among them, six underwent simple open reduction and fixation of the anterior wall, eight underwent sinus
obliteration, and three underwent cranialization. Two patients who underwent sinus
obliteration died due to infection-related complications. The patient who underwent cranialization reported experiencing chronic headache and expressed dissatisfaction regarding the esthetic outcomes of the forehead. Except for these three patients, the other patients achieved satisfactory esthetic and functional recovery.
CONCLUSIONS: Active surgical management of frontal sinus injuries is often required owing to the various complications caused by these injuries; however, several factors, including the fracture type, clinical presentation, related craniomaxillofacial injury, and medical history, should be considered while formulating the treatment plan. Surgical treatment through the opening of the frontal sinus should be actively considered in patients with severely damaged posterior wall fractures and those at risk of developing infection.