Surgical tactics for injuries of the anterior walls of the frontal sinuses

Objective. To determine the optimal surgical approach for frontal sinus injuries to avoid postoperative complications.
Material and methods. A prospective cohort study was conducted at the 426th Military Hospital of the Ministry of Defense of the Russian Federation from December 2021 to April 2025. It included 42 male patients aged 22 to 43 years with frontal sinus injuries. We studied the impact of the choice of surgical approach, open bicoronal with fatty obliteration of the sinus versus combined (bi)eyebrow with endonasal video-based navigation while preserving the sinus, on the postoperative outcome.
Results. When comparing the studied parameters, such as skin sensitivity impairment at the site of surgical intervention, impairment area, impairment persistence, presence of post-traumatic frontal sinusitis, and visible scar depending on the surgical approach, statistically significant differences between the groups were established in all cases (p<0.001).
Conclusion. The use of (bi)eyebrow access with endonasal video-based navigation allows to reduce the frequency of postoperative skin sensitivity impairment, its area, accelerate the process of sensitivity restoration, prevent the appearance of a visible extensive scar, reduce the incidence of postoperative frontal sinusitis.
Keywords: frontal sinus, delayed reconstruction issues, comminuted fractures of the frontal sinus walls, bicoronal approach, bi-eyebrow approach
Conflict of interest. The authors declare that there is no conflict of interest.
Funding. The study has not received any funding.