Risk of frontal sinus anterior table fractures after craniofacial trauma and the role of anatomic variations in frontal sinus size: a retrospective case-control study

Publication date: Available online 18 January 2019

Source: Journal of Cranio-Maxillofacial Surgery

Author(s): Johannes Buller, Matthias Kreppel, Volker Maus, Matthias Zirk, Joachim E. Zöller

Introduction

Purpose of this study was to evaluate a probable risk of frontal sinus size for traumatic depressed anterior table fractures in patients with similar forehead trauma.

Methods

We conducted a retrospective case-control study with a case group of consecutive treated patients with displaced frontal sinus anterior table fractures. The control group was randomly sampled from patients who presented with a blunt forehead trauma in our institution's emergency unit. In computed tomography data sets, all patients' frontal sinus size was categorized by Guerram's classification that is defined as aplasia, hypoplasia, medium-size and hyperplasia. Odds for prevalence of the sinus types as well as sinus total width and height were compared between both groups.

Results

In total, 47 cases and 93 controls were identified. Hyperplasia in the case group had an odds ratio of 46:1 (p<0.001) compared to the controls. Mean sinus width (73 mm vs. 46 mm; p<0.001) and sinus height (30 mm vs. 15 mm; p<0.001) were larger in the case group.

Conclusion

Depressed traumatic fractures of the anterior table are an injury with a high risk specific for enlarged frontal sinus sizes. Anatomy is the predictive factor for this mode of craniofacial trauma.

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