{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T20:24:16Z","timestamp":1793823856942,"version":"4.6.1"},"reference-count":23,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T00:00:00Z","timestamp":1714435200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Craniomaxillofacial Trauma &amp; Reconstruction"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec><jats:title>Study Design<\/jats:title><jats:p> Retrospective cohort study. <\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p> Frontal sinus fractures (FSFs) can lead to a range of clinical challenges, including facial deformity, impaired facial sensation, cerebrospinal fluid (CSF) leakage, sinus drainage impairment, chronic sinus pain and mucocele formation. The optimal management approach, whether surgical or conservative, remains a topic of ongoing discussion. The aim of this study was to evaluate and compare the functional and esthetic outcomes of patients with surgically and conservatively treated FSFs. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> In this retrospective study, patients treated for FSFs at the Karolinska university hospital 2004 to 2020 were identified in hospital records and invited to participate in a long-term follow-up. Sequelae and satisfaction with the esthetic result were assessed trough questionnaires and physical examinations. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> A total of 93 patients were included in the study, with 49 presenting isolated anterior wall fractures and 44 presenting combined anterior and posterior wall fractures. Surgical intervention was performed in 45 cases, while 48 were managed conservatively. Among patients with moderate anterior wall fractures (4-6\u00a0mm dislocation), 80% of surgically treated patients compared to 100% of conservatively treated patients expressed satisfaction with their cosmetic outcomes at follow-up ( P = .03). In conservatively treated patients with a forehead impression, the anterior wall fracture dislocation ranged from 5.3 to 6.0\u00a0mm ( P &lt; .0001). Approximately 50% of surgically treated patients vs 15% of conservatively treated patients developed impaired forehead sensation at follow-up ( P = .03). Thirty-six percent of surgically treated patients reported dissatisfaction with surgery-related scarring, particularly those who underwent surgery via laceration or bicoronal incision. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> This study suggests that anterior FSFs with a dislocation of 5\u00a0mm or less can be effectively managed conservatively with high patient satisfaction, low risk of long-term forehead sensation impairment and without potential development of forehead impression. Bicoronal incision or incision via a laceration may be associated with esthetic dissatisfaction and late sequelae such as alopecia. <\/jats:p><\/jats:sec>","DOI":"10.1177\/19433875241250225","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T11:12:54Z","timestamp":1714475574000},"page":"NP68-NP76","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Functional and Esthetic Outcomes of Either Surgically or Conservatively Treated Anterior Frontal Sinus Wall Fractures: A Long-Term Follow-Up"],"prefix":"10.3390","volume":"17","author":[{"given":"Oscar","family":"Solmell","sequence":"first","affiliation":[{"name":"ENT, Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Sunnergren","sequence":"additional","affiliation":[{"name":"Ear, Nose & Throat Clinic, Region J\u00f6nk\u00f6ping County, J\u00f6nk\u00f6ping, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdul Rashid","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Department of Clinical Science Intervention and Technology, Divisions of Baxter Novum and Renal Medicine, Karolinska Institute, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Alinasab","sequence":"additional","affiliation":[{"name":"ENT, Head and Neck Surgery, Karolinska University Hospital, Stockholm, Sweden"},{"name":"Department of Clinical Sciences, Intervention and Technology, Division of Otorhinolaryngology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,30]]},"reference":[{"key":"bibr1-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000006706"},{"key":"bibr2-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1269766"},{"key":"bibr3-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1234020"},{"key":"bibr4-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198806000-00002"},{"key":"bibr5-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000007426"},{"key":"bibr6-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2014.14"},{"key":"bibr7-19433875241250225","doi-asserted-by":"publisher","DOI":"10.7181\/acfs.2017.18.4.230"},{"key":"bibr8-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0b013e31824dfcb1"},{"key":"bibr9-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1097\/scs.0b013e318052ff45"},{"key":"bibr10-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215121001006"},{"key":"bibr11-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2021.08.006"},{"key":"bibr12-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcms.2014.04.023"},{"key":"bibr13-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880110109"},{"key":"bibr14-19433875241250225","doi-asserted-by":"publisher","DOI":"10.7181\/acfs.2017.18.1.1"},{"key":"bibr15-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000691"},{"key":"bibr16-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31818d58ba"},{"key":"bibr17-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1097\/SCS.0000000000004984"},{"key":"bibr18-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2016.04.008"},{"key":"bibr19-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.03.043"},{"key":"bibr20-19433875241250225","doi-asserted-by":"publisher","DOI":"10.4103\/0975-5950.196143"},{"key":"bibr21-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26601"},{"key":"bibr22-19433875241250225","doi-asserted-by":"publisher","DOI":"10.1001\/jamafacial.2016.1741"},{"key":"bibr23-19433875241250225","doi-asserted-by":"publisher","DOI":"10.7181\/acfs.2016.17.4.218"}],"container-title":["Craniomaxillofacial Trauma &amp; 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