Journal of Oral and Maxillofacial Surgery
Volume 68, Issue 9 , Pages 2041-2046, September 2010

Complications of Frontal Sinus Fractures With Emphasis on Chronic Craniofacial Pain and Its Treatment: A Review of 43 Cases

  • L. Anthony Sivori II, DMD

      Affiliations

    • Resident, Division of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, Lexington, KY
  • ,
  • Reny de Leeuw, DDS, PhD

      Affiliations

    • Associate Professor and Division Chief, Orofacial Pain Center, University of Kentucky College of Dentistry, Lexington, KY
  • ,
  • Isaac Morgan, DMD

      Affiliations

    • Resident, Oral and Maxillofacial Surgery, University of Tennessee, Knoxville, TN
  • ,
  • Larry L. Cunningham Jr, DDS, MD

      Affiliations

    • Associate Professor, Residency Director, and Chief, Division of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, Lexington, KY
    • Corresponding Author InformationAddress correspondence and reprint requests to Dr Cunningham, Jr: Department of Oral and Maxillofacial Surgery, University of Kentucky College of Dentistry, 800 Rose Street, D-508, Lexington, KY 40536-0297

Purpose

Frontal sinus fractures constitute 5% to 12% of all facial fractures. The optimal management of frontal sinus fractures is controversial but involves preserving the function of the nasofrontal ducts when feasible. We reviewed the postoperative complications of a series of 43 patients treated surgically for frontal sinus fractures.

Materials and Methods

The data from 43 patients treated from 2000 to 2006 were reviewed. The information reviewed included patient age and gender, mechanism of injury, type of frontal sinus injury, associated facial injuries, treatment method, and complications. The institutional review board approved the present study.

Results

The average patient age was 32.5 years; 36 were men and 7 were women. Of the 43 patients, 23 (53.5%) had had anterior table fractures and 20 (46.5%) had had both anterior and posterior table fractures. Postoperative complications occurred in 7 patients (16.3%). Of these 7 patients, 2 experienced continued headache and pain and required surgical removal of infected hardware, 3 also experienced frequent headaches and pain in the frontal-temporal region, 1 had a post-traumatic deformity, and 1 developed periorbital cellulitis and abscess formation within the frontal sinus.

Conclusion

Frequent headaches and complaints of continued pain were the most common complications experienced by our series of patients. We also reviewed treatment strategies for postoperative follow-up and treatment of chronic pain.

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PII: S0278-2391(10)00585-9

doi:10.1016/j.joms.2010.05.041

Journal of Oral and Maxillofacial Surgery
Volume 68, Issue 9 , Pages 2041-2046, September 2010