Fracture of the skull involving the paranasal sinuses and mastoids is important mainly because it exposes the brain to infection. Less serious effects are paralysis of cranial nerves and facial deformity from displacement or loss of bone fragments.
Fractures of the skull, whether of the vault or base or, as they usually are, of the two in combination, frequently produce serious damage to the brain, and the brain injury should receive primary consideration. Fracture of a paranasal sinus is often only a minor effect of an injury which damages important regions of the brain at the base of the skull and severely macerates the cerebral cortex by the indriven fragments of an associated compound fracture of the vault. Consideration of the sinus fracture in serious cases of head trauma must at times be postponed or even entirely abandoned in favor of a management which gives the patient the best chance
COLEMAN CC. FRACTURE OF THE SKULL INVOLVING THE PARANASAL SINUSES AND MASTOIDS. JAMA. 1937;109(20):1613–1616. doi:10.1001/jama.1937.02780460023005
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