REVIEW

Fratura do seio frontal. Condutas e desafios: uma revisão de literatura

Frontal sinus fracture. Conducts and challenges: a literature review

  • Lauro Roberto de Azevedo Setton (1)
  • Antonio Roberto Ferreira Setton (2)(3)
  • Yuri Mark dos Santos Ribeiro (4)
  • Mathias Luca Melo Alves (1)
  • Carlos Umberto Pereira (5)
  Views: 1101
  Downloads: 132

Resumo

Introdução: A fratura do seio frontal (FSF) é uma entidade de grande importância devido à sua incidência e tratamentos complexos, ocorre em cerca de 5 a 15% dos traumas de face e se apresenta quatro vezes mais em homens. O tratamento da FSF varia da observação clínica até o processo cirúrgico de cranialização do seio. Objetivo: O presente estudo pretende nortear a comunidade médica a respeito do cenário atual do manejo das fraturas de seio frontal, principais condutas e desafios. Metodologia: Trata-se de uma revisão de literatura utilizando as bases de dados PubMed, Google Scholar e Scielo utilizando os termos: “Frontal sinus”, “Frontal bone” e “Facial injuries”. Foram selecionados artigos de 2006 a 2022, resultando em 52 artigos que foram submetidos à revisão sistemática. Resultados: Existe uma grande controvérsia com relação ao tratamento específico empregado nos casos de FSF, devendo-se levar em conta que mais benefícios têm se mostrado em técnicas conservadoras em detrimento das terapêuticas mais agressivas. Conclusão: A literatura tem demonstrado um melhor desfecho nos tratamentos conservadores em detrimento dos cirúrgicos quando estes são passíveis de eleição e os prejuízos da falta de uma classificação unificada para as fraturas de seio frontal em especial na população pediátrica.

Palavras-chave

Seio frontal; Traumatismo cranioencefálico; Tratamento; Complicações

Abstract

Introduction: The frontal sinus fracture (FSF) is an entity of great importance due to its incidence and complex treatment, it occurs in about 5-15% of facial traumas and presents four-fold number more in men. The treatment of FSF varies from clinical observation to the surgical process of sinus cranialization. Objective: The present study aims to guide the medical community regarding to the current scenario of the management of frontal sinus fractures, main conducts and challenges. Methodology: This is a literature review using PubMed, Google Schollar and Scielo databases using the terms: “Frontal sinus”, “Frontal bone” and “Facial injuries”. Articles from 2006 to 2022 were selected, resulting in 52 articles that were submitted to a systematic review. Results: There is a great controversy regarding to the specific treatment used in cases of FSF, considering that more benefits have been shown in conservative techniques at the expense of more aggressive therapies. Conclusion: The literature has shown a better outcome in conservative treatments over surgical ones when these are amenable to be chosen and the disadvantages of the lack of a unified classification for frontal sinus fractures, especially in the pediatric population.

Keywords

Frontal sinus; Traumatic brain injury; Treatment; Complications

References

1. Santos DFS, Santos ES, Gomes GMF Jr, et al. Osteossíntese de

fratura de parede anterior do seio frontal - relato de caso. BJHR.

2020;3(3):6957-64. http://dx.doi.org/10.34119/bjhrv3n3-230.

2. Fernandes BDR, Mandarino S, Gomes-Ferreira PHS, et al.

Tratamento de fratura do seio frontal, por meio de cranialização,

obliteração, redução e fixação das fraturas: relato de caso clínico.

Arch Health Invest. 2019;8:7. http://dx.doi.org/10.21270/archi.

v7i0.3910.

3. Rodrigues CMC, Sol I, Almeida VL, et al. Abordagem cirúrgica

imediata de fratura de seio frontal: relato de caso. Rev Odontol Bras

Central. 2020;29(88):39-42. http://dx.doi.org/10.36065/robrac.

v29i88.1377.

4. Matos FS, Pereira LA, Loureiro CE, Borges EFD, Moreira CVA,

Azevedo RA. Diferentes abordagens cirúrgicas para reconstrução de

fraturas em osso frontal: relato de 04 casos. BJHR. 2020;3(1):153-70.

http://dx.doi.org/10.34119/bjhrv3n1-011.

5. Rodrigues MFB, Rocha LLA, Souza DD, Acioly RF, Carvalho

DC, Rocha CCL. Tratamento tardio de fratura fronto-naso-órbitoetmoidal:

relato de caso. BJD. 2020;6(7):49924-31. http://dx.doi.

org/10.34117/bjdv6n7-589.

6. Lima ACA, Hadad H, Capalbo da Silva R, et al. Tratamento

de fratura da parede anterior de seio frontal causada por acidente

desportivo. Arch Health Invest. 2019:7. http://dx.doi.org/10.21270/

archi.v7i0.3910

7. Muller VA, Bruksch GK, Sória GS, et al. Functional recovery

time after facial fractures: characteristics and associated factors

in a sample of patients from southern Brazil. Rev Col Bras Cir.

2021;48:e20202581. http://dx.doi.org/10.1590/0100-6991e-20202581.

PMid:33470368.

8. Banica B, Ene P, Dabu A, Ene R, Cirstoiu C. Rationale

for management of frontal sinus fractures. Maedica (Bucur).

2013;8(4):398-403. PMid:24790677.

9. Castro CML, Melo IA, Souza EO No, et al. Tratamento cirúrgico

de fratura do osso frontal: relato de caso. BJD. 2021;7(3):26169-77.

http://dx.doi.org/10.34117/bjdv7n3-357.

10. Schultz K, Braun T, Truong T. Frontal sinus fractures.

Seminars in Plastic Surgery. 2017;31(2):080-4. http://dx.doi.

org/10.1055/s-0037-1601371.

11. Montovani JC, Nogueira EA, Ferreira FD, Lima Neto AC, Nakajima

V. Cirurgia das fraturas do seio frontal: estudo epidemiológico e

análise de técnicas. Rev Bras Otorrinolaringol. 2006;72(2):204-9.

http://dx.doi.org/10.1590/S0034-72992006000200009.

12. Silva JRD, Mourão CFDAB, Rocha HVD Jr, Magacho LF, Moraes

GFD, Homsi N. Treatment of frontal bone fracture sequelae through

inversion of the bone fragment. Rev Col Bras Cir. 2016;43(6):472-5.

http://dx.doi.org/10.1590/0100-69912016006011. PMid:28273220.

13. Hoshal SG, Dedhia RD, Strong EB. Frontal sinus fractures: a

contemporary approach in the endoscopic era. Facial Plast Surg

Clin North Am. 2022;30(1):71-83. http://dx.doi.org/10.1016/j.

fsc.2021.08.006. PMid:34809888.

14. Pavoni RF, Sangalette BS, Capelari MM, Toleto JL No, Toledo

GL. Limite de atuação em cirurgia bucomaxilofacial – fratura da

parede anterior do seio frontal. BJD. 2022;8(3):17485-93. http://

dx.doi.org/10.34117/bjdv8n3-131.

15. Srinivasa R, Furtado SV, Sansgiri T, Vala K. Management of

frontal bone fracture in a tertiary neurosurgical care center—a

retrospective study. J Neurosci Rural Pract. 2022;13(1):060-6. http://

dx.doi.org/10.1055/s-0041-1740615.

16. Bisson EF, Ravindra VM, Neil JA, Shah LM, Schmidt RH. Surgical

management of traumatic frontal sinus fractures: case series from a

single institution and literature review. Surg Neurol Int. 2015;6:141.

http://dx.doi.org/10.4103/2152-7806.163449. PMid:26392917.

17. Santos RD, Cavalheiro PM, Comunello IF, Campos M, Luckmann

G. Redução de seio frontal: abordagem bucomaxilofacial na terapia

de reabilitação das fraturas panfaciais. RFO Rev Fac Odontologia.

2018;23(1):42-7. http://dx.doi.org/10.5335/rfo.v23i1.7613.

18. Elkahwagi M, Eldegwi A. What is the role of the endoscope in

the sinus preservation management of frontal sinus fractures? J Oral

Maxillofac Surg. 2020;78(10):1811.e1-9. http://dx.doi.org/10.1016/j.

joms.2020.04.025. PMid:32446806.

19. Onișor-Gligor F, Țenț PA, Bran S, Juncar MA. A Naso-Orbito-

Ethmoid (NOE) Fracture Associated with Bilateral Anterior and

Posterior Frontal Sinus Wall Fractures Caused by a Horse Kick:

Case Report and Short Literature Review. Medicina (Kaunas).

2019;55(11):731. http://dx.doi.org/10.3390/medicina55110731.

PMid:31717521.

20. Pontes KT, Andrade TI, Araújo FR, Andrade JS, Brainer DLB.

Tratamento cirúrgico de fratura do seio frontal utilizando enxerto

de pericrânio para obliteração de ducto nasofrontal: relato de caso.

Arch Health Invest. 2020;9(5):460-3. http://dx.doi.org/10.21270/

archi.v9i5.5040

21. Jaźwiec AM, Rechner B, Komorowska-Timek E. Endoscopyassisted

frontal sinus obliteration. J Craniofac Surg. 2018;29(5):e513-5.

http://dx.doi.org/10.1097/SCS.0000000000004562. PMid:29762325.

22. Lopez J, Pineault K, Pradeep T, et al. Pediatric frontal bone and

sinus fractures: cause, characteristics, and a treatment algorithm.

Plast Reconstr Surg. 2020;145(4):1012-23. http://dx.doi.org/10.1097/

PRS.0000000000006645. PMid:32221225.

23. Kinzinger M, Steele TO, Chin O, Strong EB. Degree of frontal

bone exposure via upper blepharoplasty incision. considerations for

frontal sinus fracture. Otolaryngol Head Neck Surg. 2019;160(3):468-

71. http://dx.doi.org/10.1177/0194599818825456. PMid:30667301.

24. Grayson JW, Jeyarajan H, Illing EA, Cho DY, Riley KO, Woodworth

BA. Changing the surgical dogma in frontal sinus trauma: transnasal

endoscopic repair. Int Forum Allergy Rhinol. 2017;7(5):441-9. http://

dx.doi.org/10.1002/alr.21897. PMid:28207197.

25. Banks C, Grayson J, Cho DY, Woodworth BA. Frontal sinus

fractures and cerebrospinal fluid leaks: a change in surgical paradigm.

Curr Opin Otolaryngol Head Neck Surg. 2020;28(1):52-60. http://

dx.doi.org/10.1097/MOO.0000000000000602. PMid:31834027.

26. Al-Moraissi EA, Alyahya A, Ellis E. Treatment of frontal

sinus fractures: a systematic review and meta-analysis. J Oral

Maxillofac Surg. 2021;79(12):2528-36. http://dx.doi.org/10.1016/j.

joms.2021.06.013. PMid:34252369.

27. Dedhia RD, Morisada MV, Tollefson TT, Strong EB. Contemporary

management of frontal sinus fractures. Curr Opin Otolaryngol

Head Neck Surg. 2019;27(4):253-60. http://dx.doi.org/10.1097/

MOO.0000000000000546. PMid:31116143.

28. Al-Shami H, Alnemare AK, Mahfoz TB, Salah AM. Traumatic

frontal sinus fractures management: experience from high-trauma

centre. Korean J Neurotrauma. 2021;17(1):15-24. http://dx.doi.

org/10.13004/kjnt.2021.17.e3. PMid:33981639.

29. Hahn HM, Lee YJ, Park MC, Lee IJ, Kim SM, Park DH. Reduction

of closed frontal sinus fractures through suprabrow approach.

Arch Craniofac Surg. 2017;18(4):230-7. http://dx.doi.org/10.7181/

acfs.2017.18.4.230. PMid:29349046.

30. Tonini KR, Hergesel de Oliva A, Borges Duailibe de Deus C, et al.

Fratura de osso frontal associada à fratura de teto orbitário do tipo

blow-in. Arch Health Invest. 2019;7

31. Tallal RE, Estawrow MA. Obliteration and contouring of

comminuted anterior wall frontal sinus fracture using pericranial

flaps. Plast Reconstru Surg - Global Open. 2021;9(8):e3670. http://

dx.doi.org/10.1097/GOX.0000000000003670.

32. Bozkurt G, Zocchi J, Russo F, et al. Frontal sinus preservation during

cerebrospinal fluid leak repair. J Craniofac Surg. 2019;30(8):e763-8.

http://dx.doi.org/10.1097/SCS.0000000000005764. PMid:31348205.

33. Arnold MA, Tatum SA 3rd. Frontal sinus fractures:

evolving clinical considerations and surgical approaches.

Craniomaxillofac Trauma Reconstr. 2019;12(2):85-94. http://dx.doi.

org/10.1055/s-0039-1678660. PMid:31073357.

34. Teslenco VB, Barros MAN, Cavalcanti HA, Reis GN. Tratamento

cirúrgico de fratura fronto-naso-órbito-etmoidal e terço médio

através de abordagem coronal: relato de caso. Arch Health Invest.

2021;10(3),4803. http://dx.doi.org/10.21270/archi.v10i3.4725.

35. Vincent A, Wang W, Shokri T, Gordon E, Inman JC, Ducic

Y. Management of frontal sinus fractures. Facial Plast Surg.

2019;35(6):645-50. http://dx.doi.org/10.1055/s-0039-3399521.

PMid:31783422.

36. Kim YW, Lee DH, Cheon YW. Secondary reconstruction of

frontal sinus fracture. Arch Craniofac Surg. 2016;17(3):103-10.

http://dx.doi.org/10.7181/acfs.2016.17.3.103. PMid:28913266.

37. Naidu PB , Rajan VT, Truman Srinivas, Selvakumar K. Linear

frontal bone fractures - clinical and surgical profile: a retrospective

study. Trauma Mon. 2016;23(1). http://dx.doi.org/10.5812/

traumamon.41657.

38. Eledeissi A, Ahmed M, Helmy E. Frontal Sinus Obliteration

Utilizing Autogenous Abdominal Fat Graft. Open Access Maced

J Med Sci. 2018;6(8):1462-7. vailable from: https://dx.doi.

org/10.3889%2Foamjms.2018.295. http://dx.doi.org/10.3889/

oamjms.2018.295. PMid:30159078.

39. Robiony M, Della Pietra L, Bertossi D, Albanese M, Fresku A. A

simple method for the repair of frontal sinus fracture: the bone mesh

pull-up technique. Craniomaxillofac Trauma & Reconstr. 2014;7(1):79-

83. https://doi.org/10.1055%2Fs-0033-1364201.

40. Jin HR, Shim WS, Jung HJ. Minimally invasive technique to reduce

the isolated anterior wall fracture of the frontal sinus. J Craniofac Surg.

2019;30(8):2375-7. http://dx.doi.org/10.1097/SCS.0000000000005931.

PMid:31592841.

41. Oliveira ACJ, Conci RA, Sbardelotto BM, Garbin EA Jr, Griza GL.

Surgical treatment of fracture in the anterior table of the frontal sinus.

RSD. 2020;9(9):e850998118. https://doi.org/10.33448/rsd-v9i9.8118.

42. Jeevitha JY, Meyyappan A, Jagdish E. Bone cements in depressed

frontal bone fractures. Ann Maxillofac Surg. 2019;9(2):407-10. http://

dx.doi.org/10.4103/ams.ams_155_19. PMid:31909025.

43. Dassi CS, Demarco FR, Mangussi-Gomes J, Weber R, Balsalobre L,

Stamm AC. The frontal sinus and frontal recess: anatomical, radiological

and surgical concepts. Int Arch Otorhinolaryngol. 2020;24(3):e364-75.

http://dx.doi.org/10.1055/s-0040-1713923. PMid:32754249.

44. Kolarkodi SH, Alyahya Y, Javed MQ, Bava FA, Mariyam

MN. Supraorbital rim fracture involving frontal sinus by sports injury.

Cureus. 2020;12(12):e12003. http://dx.doi.org/10.7759/cureus.12003.

PMid:33457114.

45. Pizzolato VL, Barbosa S, Polo TOB, et al. Retalho de pericrânio

como alternativa durante obliteração do ducto nasofrontal e seio frontal:

relato de dois casos. Rev Odontol UNESP. [Internet]. 2022 [Accessed:

31/5/2022];50(N Esp):48. Available from: https://revodontolunesp.

com.br/article/61d72a51a9539568be482d12

46. Buller J, Kreppel M, Maus V, Zirk M, Zöller JE. Risk of frontal sinus

anterior table fractures after craniofacial trauma and the role of anatomic

variations in frontal sinus size: a retrospective case-control study. J

Craniomaxillofac Surg. 2019;47(4):611-5. http://dx.doi.org/10.1016/j.

jcms.2019.01.018. PMid:30718214.

47. Ortiz-Galloza EX, Arechiga B, Heer J, Quesada D. Delayed tension

pneumocephalus following frontal sinus fracture. CPC-EM. 2022;6(1):81-

4. http://dx.doi.org/10.5811/cpcem.2021.9.53603. PMid:35226857.

48. Dayashankara Rao JK, Malhotra V, Batra RS, Kukreja A. Esthetic

correction of depressed frontal bone fracture. Natl J Maxillofac

Surg. 2011;2(1):69-72. http://dx.doi.org/10.4103/0975-5950.85858.

PMid:22442614.

49. Destiansyah RA, Rahmadhan MA, Niantiarno FH, et al.

Modification of periosteal flap as management of cerebrospinal fluid

leakage after frontal sinus fracture surgery in moderate traumatic

brain injury patients. Asian J Neurosurg. 2020;15(4):1076-80. http://

dx.doi.org/10.4103/ajns.AJNS_206_19. PMid:33708693.

50. Noiphithak R, Yanez‐Siller JC, Nimmannitya P, Rukskul P.

Transorbital endoscopic approach for repair of frontal sinus cerebrospinal

fluid leaks: case‐series. Laryngoscope. 2021;131(8):1753-7. http://dx.doi.

org/10.1002/lary.29161. PMid:33009848.

51. Jahanshahi J, Zeinalizadeh M, Reza Mohammadi H, Sadrehosseini

SM. Endonasal endoscopic management of frontal sinus cerebrospinal

fluid leak. Am J Rhinol Allergy. 2017;31(6):406-11. http://dx.doi.

org/10.2500/ajra.2017.31.4478. PMid:29122086.

52. Tanusantoso A, Adiantoro S, Sjamsudin E, Yusuf H. Management

of facial bone fractures with frontonasal open head injury: case

report. Int J Med Rev Case Rep. 2020;4(7):69-73. http://dx.doi.

org/10.5455/IJMRCR.2020-07-254.


1 Medical student, University Tiradentes, Aracaju, SE, Brazil.

2 MD, PhD, Otorrhinolaryngologist, Service of ORL, Hospital de Urgências de Sergipe – HUSE, Aracaju, SE, Brazil.

3 Auxiliar coordinator, Program of Hearing Health, São Jose Hospital, Aracaju, SE, Brazil.

4 MD, Emergency Medicine, Ala Vermelha, Hospital de Urgências de Sergipe – HUSE, Aracaju, SE, Brazil.

5 MD, PhD, Neurosurgeon, Neurosurgery Service, Hospital de Urgências de Sergipe – HUSE, Aracaju, SE, Brazil.

 

Received May 31, 2022

Accepted Jul 12, 2022

JBNC  Brazilian Journal of Neurosurgery

  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786

Contact

Social Media

   

ABNc  Academia Brasileira de Neurocirurgia

  •   Rua da Quitanda 159 – 10º andar - Centro - CEP 20091-005 - Rio de Janeiro - RJ
  •   +55 21 2233.0323
  •    abnc@abnc.org.br

Sponsor

  • Brain4Care
  • Hospital INC
  • Strattner