The Skull Base Trauma: Management and Treatment

Abstract

Our group had 214 patients: the anterior skull base 146, middle 64, posterior 2, and 2 patients with post-traumatic exchange volume of orbital space and their reconstruction. During anterior skull base reconstruction, we protected the olfactory structures in 91%. Mortality rate in our series was 1.7%, post-traumatic morbidity 17%, and postoperative morbidity 0.6%. Follow-up in this series was 14 years. We studied different pathological post-traumatic problems in olfactory structures-destruction or contusion or hematoma of the olfactory bulb, destruction of the olfactory tract, and destruction or contusions in the olfactory trigonum. In our series we preferred acute operations and reconstructions of open skull base fracture with very effective goals. In the reconstruction method we preferred vascularized flaps for reconstruction of dura. The authors discuss problems of acute and delayed reconstruction, and mortality and morbidity. The authors have 14 years' experience with acute operations and reconstructions, diagnostic techniques, treatment, and follow-up of patients.