Nose and paranasal sinuses: frontal sinus posterior table fracture: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Nose and paranasal sinuses: frontal sinus posterior table fracture

Sample item

After a road accident a man has a depressed forehead. CT shows a comminuted, displaced posterior table fracture of the frontal sinus with pneumocephalus and clear nasal fluid. What is the appropriate surgical management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Exploration with cranialisation of the frontal sinus

A displaced posterior table fracture with a dural tear and CSF leak needs surgical exploration. Cranialisation removes the posterior wall and the sinus mucosa, allows the brain to expand into the sinus space, and prevents later mucocele and intracranial infection. Anterior table deformity is then reconstructed.

Option by option

  • A. Exploration with cranialisation of the frontal sinus (correct)

    Correct. Cranialisation is used for displaced posterior table fractures with a CSF leak.

  • B. Observation with antibiotics alone

    Observation risks meningitis and mucocele with a dural breach.

  • C. Balloon dilatation of the frontal recess

    Balloon dilatation treats chronic frontal sinus outflow disease and not trauma.

  • D. Caldwell-Luc operation

    Caldwell-Luc is an approach to the maxillary antrum.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is A, Exploration with cranialisation of the frontal sinus. A displaced posterior table fracture with a dural tear and CSF leak needs surgical exploration.

Why is "Observation with antibiotics alone" not the answer?

Observation risks meningitis and mucocele with a dural breach.

Why is "Balloon dilatation of the frontal recess" not the answer?

Balloon dilatation treats chronic frontal sinus outflow disease and not trauma.

Why is "Caldwell-Luc operation" not the answer?

Caldwell-Luc is an approach to the maxillary antrum.

What concept does this question test?

It tests Nose and paranasal sinuses: frontal sinus posterior table fracture in ENT. Cranialisation removes the posterior wall and the sinus mucosa, allows the brain to expand into the sinus space, and prevents later mucocele and intracranial infection. Anterior table deformity is then reconstructed.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nose and paranasal sinuses: frontal sinus posterior table fracture?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.