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Le fort fracture case report9/1/2023 Head injury, Frontal sinus, Outer table, Fracture The first impression that come across mind of surgeon at trauma bay that penetrating head injury in frontal region with history of unconsciousness most likely to cause brain injury, this case shows no cranialization/craniotomy is required in every case of penetrating injury and careful decision making save patient from post-operative morbidity. There is no post-operative complication in subsequent follow-up. Patient was treated with open reduction and internal fixation. Cranialization, obliteration, reconstruction, observation, and endoscopic sinus surgery are available treatment modalities. With availability of CT scan, extent of injury was measured. Though there is no apparent neurological deficit on time of presentation but brief episode of unconsciousness and questionable convulsion activity just after injury raise the question of possible brain insult and requirement of cranial opening. Only anterior table injury of frontal sinus is rare in penetrating head injury without underlying brain injury with history of unconsciousness and questionable convulsion which is new to existing literature.Ī 72-years-old patient came with the history of road traffic accident and a piece of wooden block penetrating forehead. Frontal sinus injuries may range from isolated anterior table fractures causing a simple aesthetic deformity to complex fractures involving the frontal recess, orbits, skull base, and intracranial contents. Injury involving only frontal sinus is uncommon and unique as its management algorithm is changing over time with development of radiological modalities as well as endoscopic intervention. Head injury is common component of any road traffic accident injury.
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