A simplified approach for the reduction of specific closed anterior table frontal sinus fractures.

We describe a simplified approach to the management of closed anterior table fractures of the frontal sinus. Forty-seven patients were diagnosed with this type of fracture during a 3-year period. Of these, 6 had minimally-invasive periosteal raising of the anterior table through a small perieyebrow skin incision, and access to the fracture was through a small trephine or the edge of the fracture itself. We compared this with the more traditional approach of a coronal flap, which was associated with an increased duration of stay in hospital and the potential for neurological complications. Surgical intervention with a minimally-invasive trephine approach provides good cosmesis, minimal blood loss, intact neurological function, and rapid recovery. This makes it an important technique to consider in carefully selected patients.