Journal of maxillofacial surgery
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Fractures of the frontal sinus are frequently seen in patients with cranio-facial injuries. Trauma to the posterior wall and more deeply located tissues: anterior fossa, dura and brain, give an indication of the seriousness of such injuries. We point out some particular aspects of our experience; in the neurosurgical approach to such lesions; we use a classification based on treatment: -when the posterior wall of the sinus is not, or only slightly damaged, we drain it using a thin suction catheter pulled through the fronto-nasal duct, kept in place for six to ten days. -when a comminuted fracture of the frontal arch occurs in the sinus area, a large cortico-cancellous onlay bone graft is used to rebuild a harmonious frontal contour and avoid the risk of secondary deformity.
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Secondary cleft lip-palate deformities frequently involve a combination of skeletal, cartilagenous, dental and muscular deformities. Correction of these deformities should be based on normalization of function by restoring normal anatomy as much as possible. Functional correction of the lip musculature is best done at the same time as surgical correction of the skeletal-dental deformities. In this article, we outline a fundamental technique for secondary lip-nose correction based on muscle reorientation and a concomitant Le Fort I maxillary osteotomy.