A fractured sinus cavity is a common finding when there is a case of a head injury due to a fall or an accident. The maxilla is not a very strong bone and is very prone to fractures due to its built. However many times fractures of the sinus cavity may also go un-noticed due to the damage suffered at other places. People who suffer from such injuries are usually children or young adults who are more likely to suffer from accidents. Sometimes a fractured sinus cavity that is not diagnosed, may lead to faulty reunion after which the patient may have to go in for corrective surgery or rhinoplasty to take care of any respiratory obstruction. One important thing to know is that if the mechanism of injury is not sought out then the treatment plan that is devised may not be adequate and again result in esthetic or functional problems.
As discussed above the common age group in which a fracture of the sinus cavity occurs is between 20-40 years and the most common reasons are trauma suffered due to a sports injury, head on collision, falls. There are many people who repeatedly suffer trauma to that area resulting in a fractured sinus cavity. You may be surprised to know that patients who have undergone corrective surgery or rhinoplasty are also at an increased risk for such fractures. The good thing is that in most cases that suffer from a fractured sinus cavity, there is no distortion of facial features. On visiting the specialist the first thing that is done is clinical examination and the patient is advised to get the radiographs done which can help in confirming the fracture. Once the fracture is established then the doctor proceeds with the treatment.
Diagnosing the fracture is not a difficult task and there are features such as nasal bleeding, swelling or edema, ecchymoses, nasal blockage, lacerations or a dislocated septum which can easily help in identifying the damage. If there are compound fractures then a diagnosis is easier to establish. Also till the time a specialist attends to the patient a thorough check-up is done to ensure there is no damage done to any other major organ or body part. A check should be done in case of a fractured sinus cavity to see if there is no CSF leakage due to a fracture in the base of the skull. A proper intra-nasal exam needs to be performed after decongestion using Adrenaline topically or even Oxymetazoline. In case the radiographs are not clear the patient is advised to go in for a CT scan as these are more sensitive and give better results in case of a fracture. However, it must be kept in mind that it is an expensive option and the patient’s paying capacity must be taken into account and these should be used in cases where there is a doubt.
Coming to the treatment advised for a fractured sinus cavity there has always been a lot of controversy regarding the treatment plan that should be used for repair. Surgical reduction immediately is usually done after establishing proper diagnosis and getting informed consent from the patient. To get the best possible esthetic results the first objective should be the management of the post-accidental edema and then the reduction to fix the fractured segments. Once the bones involved in the fracture are united and undergo re-union then repair of the fractured sinus cavity takes place side by side. Sometimes the patient may complain of pressure or nasal regurgitation on eating for a few days. The patient needs to be explained the problem and given adequate support by placing packs in place. With time the healing will take place and the total time taken to repair the fractured bone and the underlying fractured sinus cavity might take around 8 to 12 weeks.