Frontal Sinus Fractures Flashcards
3.1 Description
3.1 Large, (oblique) forehead laceration extending down to bone
On imaging, (left) frontal sinus fracture involving the anterior and posterior tables
3.2.1 On history, the MOI would be important to
determine severity and type of injury
Explore change in vision, loss of vision, or double vision, as
orbital injuries must be ruled out prior to considering operative intervention
Numbness of the forehead would suggest
injury to cranial nerve V1 distribution
Presence of rhinorrhea would suggest
concerns for dural injury and CSF leak
On PE, I would start by
identifying any potentially life-threatening conditions
I would identify lacerations over the forehead, glabella, or supraorbital ridge
which may be used for direct assess for repair
I would also evaluate for
palpable step-offs and/or depressions in the frontal area
I would evaluate for sensibility changes in
supraorbital/supratrochlear nerve distribution
I would examine for CSF rhinorrhea
- at the bedside, with a ring test
- testing for b-transferrin in nasal discharge
I would also test for function of
frontalis and corrugator muscles
3.2.3 On imaging I would obtain a high-resolution maxillofacial CT
and assess in both axial and coronal planes
On CT I would evaluate the
involvement of the anterior and posterior tables, determining the degree of comminution and displacement
I would evaluate the nasofrontal outflow tract for ability to
drain the frontal sinus
On CT I would also evaluate for
intracranial injuries (pneumocephalus) and other facial fractures