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1.

Discuss the physiology of the nasofrontal duct.

2.

How would you assess the viability of the nasofrontal duct in frontal sinus fracture?

3.

An 18-year-old man has a displaced fracture of the anterior table of the frontal sinus. Discuss the various available options for fixation of this fracture.

4.

Educate the group on endoscopic repair of isolated anterior table frontal sinus fractures.

5.

A 25-year-old man sustains a fracture of the frontal sinus in a motor vehicle collision. CT scans reveal an anterior table fracture that involves the nasofrontal duct.  Discuss the options.

6.

You are called to the trauma bay to evaluate a 30-year-old female with a frontal sinus fracture.  A CT scan shows a comminuted fracture of the anterior table and a linear non-displaced fracture of the posterior table. There is no evidence of cerebrospinal fluid leak. How would you manage this patient?

7.

When would you obliterate a frontal sinus and what would you use?

8.

Discuss the management of posterior table fractures with a CSF leak.

9.

How would you manage the frontal sinus mucosa during an obliteration or cranialization procedure? Support your answer with data.

10.

List the acute and late complications following frontal sinus fracture?  What is the most common late complication and how would you manage it?  Could it have been avoided?

11.

Discuss timing of operative intervention.

Reference(s):

Bellamy, J. L., Molendijk, J., Reddy, S. K., Flores, J. M., Mundinger, G. S., Manson, P. N., … Dorafshar, A. H. (2013). Severe infectious complications following frontal sinus fracture: the impact of operative delay and perioperative antibiotic use. Plastic and Reconstructive Surgery, 132(1), 154–162.