Frontal sinus fracture: Difference between revisions
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**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]] | **Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]] | ||
== | ==Evaluation== | ||
*Assess sinus involvement: | *Assess sinus involvement: | ||
**Crepitus | **Crepitus | ||
Revision as of 04:23, 22 July 2016
Background
- Requires high-energy
- Must rule-out TBI, additional fracture, and cervical spine injury
Evaluation
- Assess sinus involvement:
- Crepitus
- Laceration over fracture site is typical
- Imaging
- Head CT indicated if suspect fracture
- Assess anterior and posterior tables
- Through and through fracture require symptoms to prevent pneumocephalus, CSF leak, infection
- Assess anterior and posterior tables
- If ant wall fracture need CT to evaluate posterior wall (75% have both walls fractured)
- Head CT indicated if suspect fracture
Differential Diagnosis
Maxillofacial Trauma
- Ears
- Nose
- Oral
- Other face
- Zygomatic arch fracture
- Zygomaticomaxillary (tripod) fracture
- Related
Management
- Sinus involvement?
- If yes then give 1st gen cephalosporin or amoxicillin clavulanate
- Isolated anterior table fracture?
- Discharge with facial surgeon follow up
- Depressed fracture?
- Admit for IV antibiotics and operative repair
- Need neurosurgery or ENT for posterior wall fracture since many need surgery and IV antibiotics