2010, Number 5
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Cir Cir 2010; 78 (5)
Fractures of the posterior wall of the frontal sinus: non-surgical management and complications
Villafán-Quiroga R, Cienfuegos-Monroy R, Sierra-Martínez E
Language: Spanish
References: 20
Page: 387-392
PDF size: 345.05 Kb.
ABSTRACT
Background: Treatment of frontal sinus fractures remains controversial. If the posterior wall is fractured and there is cerebrospinal fluid leak, treatment seeks to restore the integrity of the dura and isolate the intracranial contents through the obliteration of the nasofrontal duct and cranialization. Another group supports nonoperative management CSF leakage is produced. The purpose is to avoid complications of meningitis, fistula and late sequelae. The difficulty lies in predicting which patients will develop complications. The aim of this study is to identify complications in patients with posterior wall fracture of the frontal sinus treated nonsurgically.
Methods: An observational, cross-sectional, retrospective study was conducted with 20 patients with posterior wall fractures of the frontal sinus treated nonsurgically at the
Hospital de Traumatología y Ortopedia Lomas Verdes, Service of Maxillofacial Surgery from January 2007 to October 2009.
Results: Twenty patients with posterior wall fractures of the frontal sinus were included. There were 17 males and 3 females. Fractures were divided into groups according to their degree of movement and presence of cerebrospinal fluid fistula. Postoperative complications were cerebrospinal fluid fistula and frontal abscess.
Conclusions: Nonsurgical treatment has proven to be an option, although not free from complications, the most common being CSF fistula and abscess. Future comparative studies should be carried out to define therapeutic strategies usibg clinical monitoring and long-term imaging.
REFERENCES
Lee A, Fan LT, Gin T, Karmakar MK, Ngan Kee WD. A systematic review (meta-analysis) of the accuracy of the Mallampati tests to predict the difficult airway. Anesth Analg 2006;102:1867-1878.
Paix AD, Williamson JA, Runciman WB. Crisis management during anaesthesia: difficult intubation. Qual Saf Health Care 2005;14:e5.
Wasem S, Roewer N, Lange M. Videolaryngoscopy for endotracheal intubation—new developments in difficult airway management. Anasthesiol Intensivmed Notfallmed Schmerzther 2009;44:502-508.
Salimi A, Farzanegan B, Rastegarpour A, Kolahi AA. Comparison of the upper lip bite test with measurement of thyromental distance for prediction of difficult intubations. Acta Anaesthesiol Taiwan 2008;46:61-65.
Cattano D, Panicucci E, Paolicchi A, Forfori F, Giunta F, Hagberg C. Risk factors assessment of the difficult airway: an Italian survey of 1956 patients. Anesth Analg 2004;99:1774-1779.
Oriol-López SA, Hernández-Mendoza M, Hernández-Bernal CE, Álvarez-Flores AA. Valoración, predicción y presencia de intubación difícil. Rev Mex Anest 2009;32:41-49.
Ríos-García E, Reyes-Cedeño J. Valor predictivo de las evaluaciones de la vía aérea difícil. Trauma 2005;8:63-70.
Shiga T, Wajima Z, Inoue T, Sakamoto A. Predicting difficult intubation in apparently normal patients: a meta-analysis of bedside screening test performance. Anesthesiology 2005;103:429-437.
American Society of Anesthesiologists. Practice guidelines for management of the difficult airway: an updated report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. Anesthesiology 2003;98:1269-1277.
Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, et al. A clinical sign to predict difficult tracheal intubation: a prospective study. Can Anaesth Soc J 1985;32:429-434.
Janssens M, Hartstein G. Management of difficult intubation. Eur J Anaesthesiol 2001;18:3-12.
Wilson ME, Spiegelhalter D, Robertson JA, Lesser P. Predicting difficult intubation. Br J Anaesth 1988;61:211-216.
Randell T. Prediction of difficult intubation. Acta Anaesthesiol Scand 1996;40:1016-1023.
Behringer EC. Approaches to managing the upper airway. Anesthesiol Clin North Am 2002;20:813-832.
Eberhart LH, Arndt C, Cierpka T, Schwanekamp J, Wulf H, Putzke C. The reliability and validity of the upper lip bite test compared with the Mallampati classification to predict difficult laryngoscopy: an external prospective evaluation. Anesth Analg 2005;101:284-289
Naguib M, Malabarey T, AlSatli RA, Al Damegh S, Samarkandi AH. Predictive models for difficult laryngoscopy and intubation. A clinical, radiologic and three-dimensional computer imaging study. Can J Anaesth 1999;46:748-759.
Á lvarez-Ríos JJ, Cano-Juárez GZ, López AM, Prado T, Zúñiga-Salazar G. Anestesia general. Empleo de la mascarilla laríngea (LMA) en cirugía convencional. Rev Mex Anest 2002;25:19-23.
Joo HS, Kapoor S, Rose DK, Naik VN. The intubating laryngeal mask airway after induction of general anesthesia versus awake fiberoptic intubation in patients with difficult airways. Anesth Analg 2001;92:1342-1346.
Bonilla AJ. Evaluación de la vía aérea en el paciente crítico. Rev Col Anest 2008;36:39-44.
Parmet JL, Colonna-Romano P, Horrow JC, Miller F, Gonzales J, Rosenberg H. The laryngeal mask airway reliably provides rescue ventilation in cases of unanticipated difficult tracheal intubation along with difficult mask ventilation. Anesth Analg 1998;87:661-665.