Traumatismos del seno frontal - 03/08/12

[20-475-A-10] - Doi : 10.1016/S1632-3475(12)62185-7

Y. Pons ^a : Assistant, E. Ukkola-Pons ^b : Interne, A. Crambert ^a : Interne, M. Raynal ^a : Spécialiste, P. Lepage ^a : Spécialiste, M. Kossowski ^a : Professeur agrégé
^a Service d'ORL chirurgie cervico-faciale, Hôpital d'Instruction des Armées Percy, 101, avenue Henri-Barbusse, 92140 Clamart cedex, France
^b Service d'imagerie médicale, Hôpital d'Instruction des Armées du Val de Grâce, 74, boulevard de Port-Royal, 75005 Paris cedex, France

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Articolo archiviato , inizialmente pubblicato nel trattato EMC : Otorrinolaringología

Riassunto

Los traumatismos externos del seno frontal son menos frecuentes en la actualidad gracias al uso del cinturón de seguridad y a la prevención individual y colectiva durante ciertos deportes de riesgo. El problema del tratamiento de las fracturas de los senos frontales es complejo: además de las lesiones cerebrales asociadas, debe tener en cuenta el riesgo estético de las fracturas de la pared anterior, el riesgo funcional por la repercusión de la fractura o de la reparación sobre la función de drenaje y aireación del conducto nasofrontal (origen de complicaciones a corto y largo plazo), así como el riesgo infeccioso vital por la afectación de la pared posterior del seno frontal. En este artículo se describen los principios diagnósticos y terapéuticos de los traumatismos externos del seno frontal. Los traumatismos internos relacionados con la cirugía endonasal no se detallarán.

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Palabras clave : Fractura, Lesiones cerebrales, Drenaje, Aireación, Conducto nasofrontal, Riesgo estético

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Introducción

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Pared anterior

Pared posterior

Pared inferior

Pared medial o tabique intersinusal

Conducto nasofrontal

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Estudio de un paciente con un traumatismo facial

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Anamnesis

Exploración física

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]}

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]}

Tratamiento ^{[Pons Y, Raynal M, Lepage P, Kossowski M. Traumatismes du tiers moyen de la face. EMC (Elsevier Masson SAS, Paris), Oto-rhino-laryngologie, 20-480-A-10, 2010.

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]}

Objetivos ^{[Pons Y, Raynal M, Lepage P, Kossowski M. Traumatismes du tiers moyen de la face. EMC (Elsevier Masson SAS, Paris), Oto-rhino-laryngologie, 20-480-A-10, 2010.

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]}

Métodos farmacológicos

Métodos quirúrgicos ^{[Pons Y, Raynal M, Lepage P, Kossowski M. Traumatismes du tiers moyen de la face. EMC (Elsevier Masson SAS, Paris), Oto-rhino-laryngologie, 20-480-A-10, 2010.

]}

Indicaciones quirúrgicas ^{[Peynegre R., Rouvier P. Anatomy and anatomical variations of the paranasal sinuses Diseases of the sinuses New York: Totowa: Humana Press (1996).
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, McLaughlin R.B., Rehl R.M., Lanza D.C. Clinically relevant frontal sinus anatomy and physiology Otolaryngol Clin North Am 2001 ; 34 : 1-22

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, Gonty A.A., Marciani R.D., Adornato D.C. Management of frontal sinus fractures: a review of 33 cases J Oral Maxillofac Surg 1999 ; 57 : 372-379

, Ioannides C., Freihofer H.P. Fractures of the frontal sinus: Classification and its implications for surgical treatment Am J Otolaryngol 1999 ; 20 : 273-280

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]}

Complicaciones ^{[Gerbino G., Roccia F., Benech A., Caldarelli C. Analysis of 158 frontal sinus fractures: current surgical management and complications J Craniomaxillofac Surg 2000 ; 28 : 133-139

, Gonty A.A., Marciani R.D., Adornato D.C. Management of frontal sinus fractures: a review of 33 cases J Oral Maxillofac Surg 1999 ; 57 : 372-379

, Rohrich R.J., Hollier L.H. Management of frontal sinus fractures: changing concepts Clin Plast Surg 1992 ; 19 : 219-232

, Javer A.R., Sillers M.J., Kuhn F.A. The frontal sinus unobliteration procedure Otolaryngol Clin North Am 2001 ; 34 : 193-210

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]}

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Embriología del oído externo
M. Catala, R.H. Khonsari

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