Abstract
Materials and Methods: During the period from August 1, 2011 to December 30, 2011, in the N.V. Sklifosovsky Research Institute of Emergency Medical Care, 5 patients with isolated outer table frontal sinus fracture and 11 patients with sphenoid sinus fractures and cerebrospinal fluid (CSF) leakage were treated by the endoscopic approach. In the former group, to reach depressed fragments, a 7-cm horizontal skin incision was placed 1.5 cm behind the hairline in the central plane. A rigid 4-mm, 30° endoscope with elevators was used to expose the defect in a subperiosteal plane. To repair frontal sinus fracture, we used thin (0.3 mm) titanium microplates, which were rigidly fixated by percutaneously placed 5-mm screws. Transnasal closure of sphenoid defect with 4-mm, 0° and 30° endoscopes was achieved with muscle, mucosa of middle nasal concha, or in combination with DuraSeal.
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