Fracture of the frontal sinus: Complexity of a multidisciplinary treatment

Vinicius Arruda Vasconcelos^*Lucas Cavalieri Pereira^*Ana Júlia CoralLaura Maria Diaz RodriguezBRUNO PRADO

• Piracicaba Sugarcane Suppliers Hospital, Piracicaba, Brazil

Abstract Objective: This study aims to retrospectively analyze the management of frontal sinus fractures by a single Oral and Maxillofacial Surgery (OMFS) team over an eight-year period, highlighting epidemiological characteristics, treatment strategies, and clinical outcomes. Methods: Medical records of patients diagnosed and treated for frontal sinus fractures between 2017 and 2024 in Piracicaba, São Paulo, Brazil, were reviewed. Data included demographic information, etiology, associated injuries, type of treatment, operative time, and complications. All patients were evaluated through computed tomography (CT), and treatment decisions followed a standardized institutional algorithm. Results: Forty patients (39 male, 1 female; mean age 42.9 years) were included. Traffic accidents were the most common cause (37.5%). Twenty-two patients (55%) were managed conservatively, and 18 (45%) surgically. The mean operative time was 3 hours, with a mean interval of 5 days between trauma and surgery. No intraoperative or postoperative complications were reported. The average hospital stay ranged from 3 to 7 days, depending on the presence of associated injuries. Conclusions: Frontal sinus fractures remain challenging injuries that require careful assessment of displacement, nasofrontal duct patency, and patient condition to determine the optimal management approach. Conservative treatment was effective for non-displaced fractures with a patent nasofrontal duct, whereas surgical intervention was indicated for displaced or comminuted fractures and provided satisfactory outcomes with minimal morbidity. These results reinforce the importance of standardized decision-making protocols and multidisciplinary collaboration in optimizing patient prognosis.