Abstract
Background: Anterior table frontal sinus fractures accompanied by nasofrontal duct injury require surgical correction. Extracranial approaches for anterior table osteotomies have traditionally used plain radiograph templates or a "cut-as-you-go" technique. We compared these methods with a newer technique utilizing computed tomography (CT)-guided imaging. Methods: Data of patients with acute, traumatic anterior table frontal sinus fractures and nasofrontal duct injury between 2009 and 2013 were reviewed (n = 29). Treatment groups compared were as follows: (1) CT image guidance, (2) plain radiograph template, and (3) cut-as-you-go. Frontal sinus obliteration was performed in all cases. Demographics, operative times, length of stay, complications, and osteotomy accuracy were recorded. Results: Similar demographics, concomitant injuries, operative times, and length of stay among groups were noted. No patients in the CT-guided group had perioperative complications including intraoperative injury of the dura, cerebrum, or orbital structures. In the plain radiograph template group, 25% of patients had inadvertent dural exposure, and 12.5% required take-back to the operating room for cranial bone graft donor site hematoma. In the cut-as-you-go group, 11% required hardware removal for exposure. There were no cases of cerebrospinal fluid leak, meningitis, or mucocele in any group (follow-up, 29.2 months). The CT image guidance group had the most accuracy of the osteotomies (95%) compared with plain radiograph template (85%) and the cut-as-you-go group (72.5%). Conclusions: A new technique using CT image guidance for traumatic frontal sinus fractures repair offers more accurate osteotomy and elevation of the anterior table without increased operative times or untoward sequelae.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e64-e67 |
| Journal | Journal of Craniofacial Surgery |
| Volume | 26 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2015 |
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Keywords
- anterior table frontal sinus
- CT-guided navigation
- Frontal sinus fracture
ASJC Scopus subject areas
- Surgery
- Otorhinolaryngology
Cite this
Computed tomography image guidance for more accurate repair of anterior table frontal sinus fractures. / Lee, Justine C.; Andrews, Brian T.; Abdollahi, Hamid; Lambi, Alex G.; Pereira, Clifford; Bradley, James P.
In: Journal of Craniofacial Surgery, Vol. 26, No. 1, 01.01.2015, p. e64-e67.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Computed tomography image guidance for more accurate repair of anterior table frontal sinus fractures
AU - Lee, Justine C.
AU - Andrews, Brian T.
AU - Abdollahi, Hamid
AU - Lambi, Alex G.
AU - Pereira, Clifford
AU - Bradley, James P.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background: Anterior table frontal sinus fractures accompanied by nasofrontal duct injury require surgical correction. Extracranial approaches for anterior table osteotomies have traditionally used plain radiograph templates or a "cut-as-you-go" technique. We compared these methods with a newer technique utilizing computed tomography (CT)-guided imaging. Methods: Data of patients with acute, traumatic anterior table frontal sinus fractures and nasofrontal duct injury between 2009 and 2013 were reviewed (n = 29). Treatment groups compared were as follows: (1) CT image guidance, (2) plain radiograph template, and (3) cut-as-you-go. Frontal sinus obliteration was performed in all cases. Demographics, operative times, length of stay, complications, and osteotomy accuracy were recorded. Results: Similar demographics, concomitant injuries, operative times, and length of stay among groups were noted. No patients in the CT-guided group had perioperative complications including intraoperative injury of the dura, cerebrum, or orbital structures. In the plain radiograph template group, 25% of patients had inadvertent dural exposure, and 12.5% required take-back to the operating room for cranial bone graft donor site hematoma. In the cut-as-you-go group, 11% required hardware removal for exposure. There were no cases of cerebrospinal fluid leak, meningitis, or mucocele in any group (follow-up, 29.2 months). The CT image guidance group had the most accuracy of the osteotomies (95%) compared with plain radiograph template (85%) and the cut-as-you-go group (72.5%). Conclusions: A new technique using CT image guidance for traumatic frontal sinus fractures repair offers more accurate osteotomy and elevation of the anterior table without increased operative times or untoward sequelae.
AB - Background: Anterior table frontal sinus fractures accompanied by nasofrontal duct injury require surgical correction. Extracranial approaches for anterior table osteotomies have traditionally used plain radiograph templates or a "cut-as-you-go" technique. We compared these methods with a newer technique utilizing computed tomography (CT)-guided imaging. Methods: Data of patients with acute, traumatic anterior table frontal sinus fractures and nasofrontal duct injury between 2009 and 2013 were reviewed (n = 29). Treatment groups compared were as follows: (1) CT image guidance, (2) plain radiograph template, and (3) cut-as-you-go. Frontal sinus obliteration was performed in all cases. Demographics, operative times, length of stay, complications, and osteotomy accuracy were recorded. Results: Similar demographics, concomitant injuries, operative times, and length of stay among groups were noted. No patients in the CT-guided group had perioperative complications including intraoperative injury of the dura, cerebrum, or orbital structures. In the plain radiograph template group, 25% of patients had inadvertent dural exposure, and 12.5% required take-back to the operating room for cranial bone graft donor site hematoma. In the cut-as-you-go group, 11% required hardware removal for exposure. There were no cases of cerebrospinal fluid leak, meningitis, or mucocele in any group (follow-up, 29.2 months). The CT image guidance group had the most accuracy of the osteotomies (95%) compared with plain radiograph template (85%) and the cut-as-you-go group (72.5%). Conclusions: A new technique using CT image guidance for traumatic frontal sinus fractures repair offers more accurate osteotomy and elevation of the anterior table without increased operative times or untoward sequelae.
KW - anterior table frontal sinus
KW - CT-guided navigation
KW - Frontal sinus fracture
UR - http://www.scopus.com/inward/record.url?scp=84921388322&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84921388322&partnerID=8YFLogxK
U2 - 10.1097/SCS.0000000000001246
DO - 10.1097/SCS.0000000000001246
M3 - Article
C2 - 25569422
AN - SCOPUS:84921388322
VL - 26
SP - e64-e67
JO - Journal of Craniofacial Surgery
JF - Journal of Craniofacial Surgery
SN - 1049-2275
IS - 1
ER -