Frontal Sinus Posterior Table Fractures in a Goat

Abstract

Problem The goal of this study was to investigate how patency of the nasofrontal outflow tract would affect the healing of the frontal sinus in the setting of displaced, posterior table fractures in the adult goat (Capra Hircus). Methods Prospective animal study. Posterior table fractures were created in twenty adult goats (Capra Hircus). The nasofrontal outflow tract was obstructed in 10 goats and left patent in 10. Gross, radiologic, and histological evaluation was carried out at six months post operatively. Results All posterior table fractures healed without gross or radiological evidence of mucosal ingrowth. Obstruction of the nasofrontal outflow tract resulted in an increased rate of mucocele formation. Histological analysis did not reveal significant mucosal ingrowth in either group. Conclusion An occluded nasal frontal outflow tract leads to an increase rate in mucocele formation at 6 months. There is no gross or radiographic evidence that mucosal ingrowth into the posterior table occurs at 6 months. These findings would suggest that not all significantly displaced posterior table fractures need to be surgically addressed if the nasofrontal outflow tract is patent. Significance Posterior frontal sinus table fracture treatment is based on poorly controlled animal studies from 30 years ago and small case series reports. Our aim in this study was to determine changes in the frontal sinus at 6 months after a displaced, comminuted frontal sinus fracture was created. We hope to provide evidence demonstrating that not all posterior table fractures need to be treated, especially if the nasofrontal outflow tract is intact.