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.
Keywords
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Article info
Publication history
Published online: January 13, 2020
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© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
