No2(1) 2018
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Kishchuk VМ, Bondarchuk OВ, Dmitrenko IМ, Bartsikhovsky AI,
Lobko KA,
Gritsun YaP, Isnyuk AS, Stechishin OO
Frontal sinus injury: treatment strategy |
Kishchuk Vasyl V.
National Pirogov Memorial Medical University, Vinnytsya
Department of Otolaryngology, Head of Department
Doctor of Medical Sciences, Professor
E-mail: kvv4488@ukr.net
Orchid ID: http://orcid.org/0000-0002-3390-2401
Bondarchuk Oleksandr D.
Mykola Pyrohov Vinnytsia Regional Hospital, Vinnytsia, Ukraine
E-mail: eskulap20009@gmail.com
Dmitrenko Igor V.
Mykola Pyrohov Vinnytsia Regional Hospital, Vinnytsia, Ukraine
Department of Otolaryngology
PhD
Bartsikhovsky Andrey I.
Mykola Pyrohov Vinnytsia Regional Hospital, Vinnytsia, Ukraine
Department of Otolaryngology
PhD, Associate Professor
Lobko Katerina A.
Mykola Pyrohov Vinnytsia Regional Hospital, Vinnytsia, Ukraine
Department of Otolaryngology
PhD
Gritsun Yaroslav P.
Mykola Pyrohov Vinnytsia Regional Hospital, Vinnytsia, Ukraine
Department of Otolaryngology
Assistant of the department
Isnyuk Andriy Sergiyovich
National Pirogov Memorial Medical University, Vinnytsya
Department of Otolaryngology, Assistant of the Department |
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Abstract Fractures of the frontal bone make up from 5
to 15% of all fractures of the facial skeleton. Treatment of such fractures
complicates the presence of intracranial pathology. The key factor
determining the tactics of surgical treatment of fracture of the frontal
bone is damage to its walls, and the function of frontal-nose constitution.
The gold standard for the diagnosis of fracture severity is a 1.5 millimeter
SCT. The goals of surgical treatment of fractures of the frontal bone and
sinuses are: protection of intracranial structures, sealing of the cavity of
the skull; prevention of early and late purulent-inflammatory complications;
correction of aesthetically significant deformation and restoration of the
shape of the frontal area. Surgical tactics for fractures of the walls of
the SF is determined by the degree of displacement of the bone fragments of
the anterior and posterior walls, the presence of a fracture in the region
of the frontal and nasal constitution, which leads to a violation of its
drainage function. Tactics with fractures of the walls of the SF is
determined by the degree of displacement of the bone fragments of the
anterior and posterior walls, the presence of a fracture in the region of
the frontal and nasal singing of the mouth, and is reduced to observation,
open repositioning and fixation of bone fragments with the preservation of
the function of SF, obliteration or cranialization of SF. It all depends on
the type and severity of the injury. With fractures of the anterior wall of
the SF without displacement it is necessary to observe, fracture of the
anterior wall with a displacement of more than 2 mm can cause cosmetic
significant deformation, and cause distortion of the face and repositioning
of bone fragments. The greatest controversy is the choice of tactics in the
treatment of fractures that extend over the frontal nasal constriction and
the back wall of the SF. Of great importance in choosing the method of
treatment for this category of patients is the presence of a fracture of the
posterior wall with the displacement of the debris more than the thickness
of the bone, which can lead to the posterior liquorrhea, and the development
of intracranial complications. |
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Keywords
fracture of the frontal sinus, rupture of the solid cerebellum, cranial
frontal sinus, obliteration of the frontal sinus, femoral nasal
constitution.. |
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