Neurosurgical treatment strategy of foreign body injury in anterior-middle skull base

Abstract

Objective To investigate the neurosurgical treatment strategies of the foreign body injury in anterior-middle skull base. Methods Clinical data of 68 cases with foreign body injuries in anterior-middle skull base admitted to Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University from January 2003 to December 2017 were retrospectively analyzed. The foreign bodies were removed by craniotomy in 39 cases, by endoscopic skull base surgery in 18 cases, and were pulled out directly in 11 cases. Three cases underwent endovascular treatments. Results Foreign bodies were completely removed in 65 cases and partially removed in 3 cases. Follow-up period ranged from 3 months to 3 years with the median duration of 7 months. Eye-lid infection occurred in 1 case, transient intracranial infection in 3 cases, cerebrospinal fluid leakage in 2 cases, and intracranial hemorrhage in 2 cases. No death occurred in this group. Of 53 cases with preoperative visual defect, 34 (64.2%) had visual improvement. Of 35 cases with eye movement defect, 19 (54.3%) partially recovered. Five cases with facial numbness had no recovery. Of 3 cases with paralysis, 2 had improvement. Conclusion Good outcome and low disability rate and mortality could be achieved by surgical treatment with various strategies designed based on the characteristics and locations of skull base foreign bodies. Key words: Craniocerebral trauma; Neurosurgical procedures; Foreign bodies; Skull base; Endoscope