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

## TL;DR

A new method using 3D-printed models and medical glue helps fix complex frontal sinus fractures with better results.

## Contribution

A point-of-care digital workflow combining 3D biomodeling and cyanoacrylate-assisted fixation is proposed for comminuted frontal sinus fractures.

## Key findings

- A 3D-printed biomodel guided extracorporeal reconstruction of a comminuted frontal sinus fracture.
- Cyanoacrylate adhesive (Glubran 2) was used successfully as an adjunct to titanium microplates for fragment stabilization.
- Postoperative imaging confirmed satisfactory alignment and immediate restoration of forehead contour.

## 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.