Frontal sinus fracture

• Requires high-energy
  • Must rule-out TBI, additional fx, and cervical spine injury
• Assess sinus involvement:
  • Crepitus
  • Laceration over fracture site is typical
• Imaging
  • Head CT indicated if suspect fracture
    • Assess anterior and posterior tables
      • Through and through fx require sx to prevent pneumocephalus, CSF leak, infection
• Management
  • Sinus involvement?
    • If yes then give 1st gen cephalosporin or amoxicillin clavulanate
  • Isolated anterior table fx?
    • D/C w/ facial surgeon f/u
  • Depresed fx?
    • Admit for IV abx and operative repair