Controversy about the protective role of volume in the frontal sinus after severe head trauma: larger sinus equates with higher risk of death |
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| Affiliation: | 1. Recep Tayyip Erdogan University, Medical Faculty, Department of Otorhinolaryngology, Rize, Turkey;2. Recep Tayyip Erdogan University, Medical Faculty, Department of Neurosurgery, Rize, Turkey;3. Recep Tayyip Erdogan University Medical Faculty Department of Anesthesiology and Reanimation Rize, Turkey;4. Recep Tayyip Erdogan University, Medical Faculty Department of Radiology, Rize, Turkey;5. University of Health Sciences -Samsun Health Practices and Research Center, Department of Otorhinolaryngology, Samsun, Turkey;1. Oral and maxillofacial surgery department, Leeds Dental Institute. Clarendon Way, Leeds LS2 9LU;2. Leeds Teaching Hospitals and Leeds Dental Institute;3. Leeds Teaching Hospitals and St James Institute of Oncology, Leeds Dental Institute and Leeds General Infirmary, Leeds;1. Service de Chirurgie Maxillo-faciale et Stomatologie, CHU de Nantes, 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France;2. Laboratoire des Sarcomes Osseux et Remodelage des Tissus Calcifiés (PhyOs, UMR 1238), Faculté de Médecine, 1 rue Gaston Veil, 44035 Nantes cedex, France;1. Service de Chirurgie Maxillo-faciale et Stomatologie, CHU de Nantes, 1 Place Alexis Ricordeau, 44093 Nantes Cedex 1, France;2. Laboratoire D''Ingénierie Ostéo-Articulaire et Dentaire (LIOAD), Faculté de Chirurgie Dentaire, 1 Place Alexis Ricordeau, 44042 Nantes, France |
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| Abstract: | The “crumple zone” hypothesis suggests that the paranasal sinuses protect the brain as a zone to distribute and absorb energy after trauma to the head. We investigated the relation between the size of the frontal sinus and mortality in patients with cranial trauma. All patients with head trauma admitted to the ICU between 1 January 2016 and 20 December 2017 were reviewed retrospectively. They were divided into two groups (according to their outcome) : died and survived. The volumes of the frontal sinuses and other trauma-related variables were assessed on computed tomographs (CT) on admission. Admission CT of 33 patients (24 male, and nine female, aged between 18-92 years, mean 43) were obtained. Male patients had significantly larger frontal sinuses than female (10.24 compared with 6.6 cm3). Larger sinuses were significantly associated with a worse outcome (p = 0.005). The size of the frontal sinus correlates with mortality after cranial trauma. Our findings do not confirm the “crumple zone” hypothesis, and suggest that the larger the sinus, the greater the risk of death. To our knowledge this is a new finding that warrants further validation. |
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| Keywords: | Paranasal sinus frontal sinus size craniofacial trauma Crumple zone |
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