Clinical Evaluation and Management Outcomes of Isolated Anterior Wall Frontal Sinus Fractures Fixation with Low Profile Miniplates

Abstract

Background: Frontal sinus fractures are relatively commonwith high-velocity injury trauma. Isolated anterior wall fracturesrepresent one third of all cases. The main goals offixation are to restore the premorbid aesthetic condition andto preserve a safe and functional sinus. The ideal platingsystem used for fixation of the anterior frontal wall fracturesis the micro plating system owing to its many advantages.However, it is also feasible to utilize the low-profile miniplatingsystem as it has the same advantages.Patients and Methods: A prospective study conducted onpatients admitted to trauma unit in two departments (Maxillofacialdepartment; Assiut University Hospital and PlasticSurgery Department; Qena University Hospital) from August2017 to July 2019 (two years’ duration). The study includedall patients with anterior wall fracture of frontal sinus thatneeded open reduction and internal fixation (ORIF) with sinuspreservation. Materials used: Low profile miniplate system;KLS Martin compact system; 1.5mm craniofacial plates withthickness 0.7mm, miniscrew 1.5mm with 5mm in length anddrill bit 1.1mm diameter. Statistical analysis: Data was analyzedusing the Statistical Package for Social Sciences (SPSS)version 22. p-value <0.05 was considered significant.Results: Follow-up period ranged from 6-12 months.Clinical data revealed that none of the patients complainedfrom these miniplates concerning its palpability under theskin, sensitivity to temperature changes. No plate exposureor extrusion recorded. Only two patients had wound infectionsthat resolved by antibiotic therapy. Patients complained onlyfrom minor symptoms such as pain, supraorbital paresthesiaand facial edema. CT imaging showed good fracture healing,good alignment of the anterior wall and no plate failure(fracture). Patients were satisfied with restoration of theforehead contour and excellent aesthetic results.Conclusion: Isolated anterior wall frontal sinus fracturesare common due to high incidence rate of motor car accidentsin our country. Main lines of treatment aimed to restore a safefunctional sinus, prevent forehead contour deformity andobtain good aesthetic results. These goals can be obtained byfracture fixation with this low profile miniplate system withresultant patient satisfaction.