**14. Complications**

Some complications of frontal sinus management relate to the surgical technique. The frontal branch of the facial nerve is vulnerable to injury during elevation of the coronal skin flap. The result is paralysis of the ipsilateral forehead. This complication can be avoided by elevating the lateral aspects of the coronal flap in the proper plane. Too much disruption of the temporal fat pad during the lateral dissection can cause noticeable late temporal hollowing. A noticeable or widened scar from the coronal incision may develop. Other complications relate to the nature of the injury itself.CSF leak/rhinorrhea, with or without infectious consequences, may develop despite the fact that a watertight closure of the dura is performed. Management typically involves revision surgery, although nasal packing, bed rest, and CSF decompression via lumbar drain may be helpful adjuncts.

Appropriate management of meningitis relies on early recognition of signs, such as mental status changes, fever, and nuchal rigidity. When meningitis is detected, broad-spectrum antibiotics with CSF penetration should be employed empirically, with adjustments based on the subsequent cultures. A noticeable contour defect is always a possibility in the management of frontal sinus trauma. Meticulous reduction and fixation of all bone fragments and the appropriate use of bone grafts, titanium mesh, and bone cements are critically important for avoiding this complication.

The formation of a frontal mucocele, which may progress to mucopyocele, frontal bone osteomyelitis or endbrain abscess, are well-known complications of frontal sinus fractures.
