Spontaneous ventilation of the frontal sinus after XXXX involving the frontal recess.

@entity1 @entity130 @entity174
PURPOSE: @entity174 ( @entity174 ) have potentially catastrophic consequences due to frontal recess (FR) obstruction and proximity to the brain and orbit. Lack of follow-up and ability to predict which type of @entity174 predispose to complications has biased surgeons toward definitive interventions such as sinus obliteration and cranialization. These procedures carry inherent risk and may be unnecessary in a subset of @entity1 . This study seeks to better characterize spontaneous ventilation in subjects with FSFs, including those involving the FR. MATERIALS AND METHODS: Review of a prospectively maintained @entity130 database between 2009 and 2013 at a level 1 @entity130 center. @entity1 with @entity174 with follow-up imaging (>6weeks) available were included. The medical records and imaging were reviewed for evidence of spontaneous ventilation of the frontal sinus. RESULTS: Nineteen @entity1 @entity174 in the study period with mean imaging interval of 67.4weeks (range, 6-188.4weeks). Injury mechanisms included fall (32%), assault (31%), motor vehicle accident (17%), pedestrian-versus-automobile (12%), and gunshot wound (8%). 8/19 @entity1 (42%) sustained FSFs involving the FR and 7/8 (87.5%) spontaneously ventilated by time of interval imaging. The one @entity1 with persistent radiographic sinus opacification was associated with a naso orbital ethmoid and medial orbital blowout fracture. 6/19 @entity1 (32%) sustained @entity174 sparing the FR, and all spontaneously ventilated by the time of interval imaging. 5/19 @entity1 (26%) underwent surgical intervention. CONCLUSIONS: An expectant, sinus-preserving approach to acute FSFs involving the FR is safe and effective. Etiology of re-ventilation failure may be due to tissue obstruction, rather than the frontal recess fracture itself.
