Frontal sinus fractures: a review of 132 cases.

BACKGROUND: Frontal sinus fractures peculiarity is that a wrong treatment not only could it encompass functional or aesthetical problems but also more dangerous complications: the proximity of the frontal bone to the brain, on a side, and to the nasolacrimal duct, on the other side, and therefore to the nasal cavity, lead the traumatisms occurring within this region to be at high risk of infections. MATERIALS AND METHODS: We report our experience on 132 cases of frontal sinus fracture treated from 1989 to 2005 and to present the surgical techniques performed as well as to compare the complications they reported over time to the International Literature data. 101 patients (76.5%) were treated in order to reduce and contain the isolated fractures involving the frontal sinus anterior wall, the patients presenting associated fractures of the frontal sinus anterior and posterior wall were 28 (21.2%), while the cases reporting isolated fractures of the nasolacrimal duct were 3. RESULTS: Our patients underwent follow-ups from 1 to 16 years long. We subdivided the complications found in our group into infectious and functional so that the incidence of the complications related to the sites and the treatment performed according to the specific case could be better assessed. In conclusion, the infectious and functional complications found were treated with a multidisciplinary study considering the approach to the craniofacial traumatized person is subordinated to the co-existence of general and neurological conditions requiring for their resolution different approaches and times.

[Primary amelanotic melanoma of the nasal fossa. Importance of ultrastructural study for diagnosis]. / Il melanoma amelanotico primitivo delle fosse nasali. Importanza della ricerca ultrastrutturale nella diagnosi.

Primitive malignant melanoma of the nasal fossae is rare and amelanotic melanoma of the same site is highly unusual. The present work reports a case where positive diagnosis was only possible by means of ultrastructural study. Giving evidence of the premelanosomes, this technique made it possible to differentiate from other types of cancers (in particular from olfactory neuroblastoma, non differentiated small cell carcinomas and lymphoma). Although in all cases we are dealing with malignancies, the need for a precise histological diagnosis is fundamental to work up an adequate therapeutic protocol. Given the difficulties in getting an electronic microscope in any hospital, the method used in the present case is quite significant since it made precise diagnosis possible even on bioptic fragments fixed in non buffered formalin. Finally some problems regarding diagnosis and treatment linked to diagnosis by means of electronic microscopy are discussed.