Everyday Oral Surgery NOE and Frontal Sinus Fracture Repair (with Dr. Harkaran Rana, Oculoplastic Surgeon)
Apr 28, 2025
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Markowitz-Manson Classification Simplified
- Markowitz-Manson classification hinges on the medial canthal tendon attachment and comminution.
- Type I: single central segment; Type II: common segment with tendon attached; Type III: comminuted with avulsion.
Tiered Approach To Frontal Sinus Injuries
- For frontal sinus fractures, evaluate anterior vs posterior table and nasofrontal outflow tract involvement to decide observation versus operation.
- Cranialize posterior table fractures and consider obliteration if the outflow tract cannot be restored with ENT input.
Confirm Nasofrontal Patency With CT Or Endoscopy
- Use CT and ENT endoscopy or intraoperative flushing to assess nasofrontal outflow tract patency before deciding obliteration.
- Plan joint cases with ENT or neurosurgery for complex frontal sinus or skull-base involvement.