{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:54:32Z","timestamp":1790934872880,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The morphology of the frontal sinus (FS) has long been debated as a determinant of fracture type and severity. This study aimed to evaluate the association between sinus dimensions, fracture patterns, and clinical outcomes using real\u2010world data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Tertiary trauma referral center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed the records of 48 frontal sinus fractures treated at a tertiary trauma center. Volumetric and dimensional measurements (volume, height, width, and anteroposterior depth) were obtained from CT scans. Each sinus was segmented and analyzed separately using 3D Slicer software. Sinuses were categorised according to cohort\u2010derived percentiles and established classifications. Associations between sinus anatomy, fracture type, and outcomes were analyzed using logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      While most sinus dimensions showed odds ratios greater than 1 for anterior table fractures, only the categorical analysis of sinus height demonstrated statistical significance. Cohort\u2010based high sinuses (\u2265\u200922.22\u2009mm) were associated with isolated anterior table fractures (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014, OR\u2009=\u20094.83, 95% CI: 1.38\u201316.9). When comparing sinuses with larger volumes, a similar trend towards anterior\u2010only fractures was observed, though not statistically significant. Patients with anterior\u2010only fractures had fewer displaced fractures, shorter hospitalisation, and lower rates of intracranial haemorrhage and ICU admission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Frontal sinus height appears to be the most clinically relevant parameter influencing fracture patterns. Vertically expanded sinuses may act as protective \u201ccrumple zones,\u201d mitigating posterior table involvement and severe intracranial injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.70157","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T10:37:11Z","timestamp":1786617431000},"page":"944-951","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High Sinus, Lower Risk: A Paradigm Shift in Frontal Fracture Patterns"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9781-5991","authenticated-orcid":false,"given":"Shmuel","family":"Wechsler","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Shamir (Assaf Harofeh) Medical Center  Zeriffin Israel"},{"name":"Gray Faculty of Medical and Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haim","family":"Gavriel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Shamir (Assaf Harofeh) Medical Center  Zeriffin Israel"},{"name":"Gray Faculty of Medical and Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2328-6959","authenticated-orcid":false,"given":"Limor Muallem","family":"Kalmovich","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Shamir (Assaf Harofeh) Medical Center  Zeriffin Israel"},{"name":"Gray Faculty of Medical and Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Itzhak","family":"Aronov","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Shamir (Assaf Harofeh) Medical Center  Zeriffin Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7533-0413","authenticated-orcid":false,"given":"Uri","family":"Chavkin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Shamir (Assaf Harofeh) Medical Center  Zeriffin Israel"},{"name":"Gray Faculty of Medical and Health Sciences Tel\u2010Aviv University  Tel\u2010Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchb.2004.06.001"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.2500\/ar.2013.4.0056"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1808-8694(15)30056-2"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.03.043"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.coms.2012.01.008"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-1298(20)30097-3"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e318133a87b"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198806000-00002"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2017.00493"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajpa.22532"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anl.2017.03.003"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.31729\/jnma.8859"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20583"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-016-1644-7"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.inat.2021.101318"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2018.06.020"},{"key":"e_1_2_11_18_1","first-page":"611","article-title":"Risk of Frontal Sinus Anterior Table Fractures After Craniofacial Trauma and the Role of Anatomic Variations in Frontal Sinus Size","volume":"47","author":"Buller J.","year":"2019","journal-title":"Journal of Craniofacial Surgery"},{"key":"e_1_2_11_19_1","first-page":"1094","article-title":"The \u201cCrumple Zone\u201d Hypothesis: Association of Frontal Sinus Volume and Cerebral Injury After Craniofacial Trauma","volume":"45","author":"Cai S. 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