Frontal sinus outflow tract evaluation by sagittal computed tomography in frontal sinus fracture

The status of the frontal sinus outflow tract is important in the management of frontal sinus fractures. Anatomic and mucosal obstruction of the FSOT leads to mucociliary stasis with consequent infectious complications. This has been evaluated by routine CT scan. Objectives The aim of this study was to determine the ability of MPR mainly the sagittal CT images assessing the patency of FSOT in frontal sinus fractures. Patients and methods A prospective study was carried out from December 2008 to May 2012 on 19 patients with frontal sinus fractures. Reformatted sagittal views were done besides the routine axial, coronal CT scan views as part of facial trauma workup. These views were assessed to determine the status of the nasofrontal ducts (NFD) and compared with the operative findings. Results The patency of FSOT by sagittal CT reformatted images was the same as that of the operative finding in all cases (specificity and PPV were 100%) even in patients in whom FSOT in the axial and/orcoronal views were doubtful. Conclusion Sagittal reformatted CT images are helpful in evaluating FSOT in frontal sinus fractures due to their ability to evaluate the frontal sinus in anteroposterior and superoinferior dimensions, thus aiding the surgical approach.