Appropriate Pathways and Surgical Approaches in the Fractures of the Frontal Sinus

Fractures of the frontal sinus are part of the fractures of the border between the facial and the cranial regions. They cause both aesthetic and vital problems, but also functional, requiring rapid and global care in a multidisciplinary setting. The document provides a descriptive and cross sectional study with prospective data collection, conducted in the department of Maxillofacial and Aesthetic Surgery of the Mohammed 6 Teaching Hospital of Marrakech, describe describe 18case operated for frontal sinus fractures over a 2-year period. The ideal time of repair was beyond the 72nd hour, at best between the 8th and 15th days after the reduction of cerebral and facial edema and the exclusion of any lesions that require emergency intervention. Our indications were mainly influenced by aesthetic deformities, impaction and embarrure fracture of ethmoidal and orbital roofs with clinical expression, obliteration of the naso-frontal duct, posterior wall displacement predicting dura mater laceration, and by the time to management. The coronal approach was the most indicated with 83, 33% of the cases. We realized sinus exclusion in 72.22%, cranialization in 22.77%, and repair of dura mater injuries in 27.77%. The sequelae found in 27.77%, were essentially functional and aesthetic.