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March 10, 20260 citationsOpen Access

Digitally Guided Frontal Sinus Fracture Fixation: A Point-of-Care “In-House” Biomodel Protocol with Cyanoacrylate-Assisted Fragment Stabilization

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MTManuel TousidonisSKSaad KhayatCMCristina Maza-Muela

Key Points

  • This research aims to demonstrate a new method for fixing isolated frontal sinus fractures using 3D biomodels and cyanoacrylate.
  • Developed a point-of-care digital workflow for 3D planning and printing of a biomodel.
  • Used computed tomography for fracture assessment and visualizing bone fragments.
  • Mobilized and reassembled fragments through a coronal approach with the help of the biomodel.
  • Applied cyanoacrylate adhesive as an adjunct to standard fixation methods using titanium microplates.
  • Postoperative imaging showed satisfactory alignment of the forehead contour.
  • No early complications were noted during recovery.
  • Immediate restoration of the forehead contour was achieved.

Abstract

Background/Objectives: Frontal sinus fractures are uncommon injuries that may cause persistent aesthetic deformity when the anterior wall is comminuted, as small irregular fragments are difficult to stabilize with conventional osteosynthesis alone. Methods: We describe a point-of-care digital workflow combining 3D planning/printing and cyanoacrylate-assisted fixation for an isolated comminuted anterior frontal sinus wall fracture. A young adult presented with a depressed forehead contour after assault; computed tomography confirmed at least four displaced fragments. Results: A two-part 3D-printed biomodel was manufactured in-house to visualize the defect and guide extracorporeal reconstruction. Through a coronal approach, fragments were mobilized and anatomically reassembled using the biomodel as a reference; sinonasal drainage was preserved and sinus obliteration was not required. Because fragment size and geometry limited screw purchase, a modified N-butyl-2-cyanoacrylate adhesive (Glubran 2) was applied as an adjunct to maintain reduction, followed by reinforcement with titanium microplates. Postoperative recovery was uneventful, with immediate restoration of forehead contour and no early complications; postoperative imaging confirmed satisfactory alignment. Conclusions: This case supports the feasibility of integrating point-of-care 3D biomodeling with cyanoacrylate as a coadjuvant to microplate fixation in selected comminuted frontal sinus fractures to enhance fragment handling and contour restoration.

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Cite This Study

Tousidonis et al. (2026) studied this question.

synapsesocial.com/papers/69af953870916d39fea4c994https://doi.org/10.3390/jcm15052057
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