Frontal sinus fractures: a review of trends, diagnosis, treatment, and outcomes at a level 1 trauma center in Connecticut.

The purpose of this retrospective study is to document the incidence and etiology of frontal sinus fracture at a level 1 traumacenterin Connecticut, assess the variability of management within our institution, and assess the effect on outcome over a seven-year period (January 1995-March 2002). Sixty-three cases were identified. Mean age was 31 years (92% male). The most common mechanism of injury was motor vehicle accident, followed by falls. The rates of associated facial fracture and intracranial injury were 83%, and 54% respectively. Diagnostic imaging missed two fractures. This study documents significant intrainstitutional variation in surgical management across contemporaneous primary treatment teams. There was no significant difference in outcome noted based on the treating specialty of the primary team for a given fracture type. The material used for sinus obliteration had no affect on outcome. Notable complications ofcerebrospinal fluid leak and mucocele are discussed as they contribute to current management guidelines.