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CHAPTER 3: Upper Facial Trauma

Resident Manual of Trauma to the Face, Head, and Neck

posterior sinus wall to the anterior cranial fossa, these pathological

entities can lead to the life-threatening complications of meningitis and

brain abscess.

B. Classification

Some form of classification is necessary to describe the site and

severity of injury, thus creating a meaningful treatment algorithm. First,

the fractures should be classified according to site. As shown in Table

3.1, fractures can be further described according to their type. The

classification system breaks down to a degree, because often multiple

walls are fractured and some fractures are linear while others are

displaced. The treatment plan should include addressing each individual

site and each individual type of fracture.

Table 3.1. Classification of Frontal Sinus Fractures according to Site and Type

Step 1: Fracture Site Classification Step 2: Fracture Type Classification

Anterior wall

Posterior wall

Floor

Corner

Through-and-through

Frontonasal duct

Linear

Displaced

Compound

Comminuted

Figure 3.1

Superior sagittal sinus.