Christian Schedeit , Ioanna Kalaitsidou , Nathalie Schedeit , Bradley Aebi , Kotaro Sato , Benoît Schaller
{"title":"Retrospective analysis of surgical treatment of frontobasal fractures with the new bernese skull base fracture score","authors":"Christian Schedeit , Ioanna Kalaitsidou , Nathalie Schedeit , Bradley Aebi , Kotaro Sato , Benoît Schaller","doi":"10.1016/j.adoms.2025.100569","DOIUrl":null,"url":null,"abstract":"<div><div>The aim of this study is to evaluate the success rate and effectiveness of the subcranial approach for anterior skull base fractures in comparison to findings reported in the literature. Furthermore, a clinical recommendation for this approach will be made using the new Bernese skull base score. A total of 185 adult patients with severe comminuted fractures or cerebrospinal fluid (CSF) leaks underwent open anterior skull base surgery after trauma between 2002 and 2018 in our department. We retrospectively analyzed all of these patients by evaluating preoperative symptoms, fracture types, complication rates, and long-term outcomes. The evaluation of the results of the operations is based on the cohort of 149 patients. None of the patients with a 6-month follow-up who underwent surgery using the subcranial approach developed meningitis. Of the 9 patients (6 %) who required secondary surgery at the skull base, only 1 patient (0.7 %) required repair of a CSF leak. The most common long-term complication associated with secondary skull base surgery was mucocele formation (n = 6, 4 %). Fifteen patients developed enophthalmos (8.1 %) and eleven experienced diplopia (5.9 %). In conclusion, the subcranial approach is a safe surgical technique with a low incidence of long-term complications in comminuted fractures of the anterior skull base which is indicated for the rare severer cases.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100569"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in Oral and Maxillofacial Surgery","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S266714762500055X","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
The aim of this study is to evaluate the success rate and effectiveness of the subcranial approach for anterior skull base fractures in comparison to findings reported in the literature. Furthermore, a clinical recommendation for this approach will be made using the new Bernese skull base score. A total of 185 adult patients with severe comminuted fractures or cerebrospinal fluid (CSF) leaks underwent open anterior skull base surgery after trauma between 2002 and 2018 in our department. We retrospectively analyzed all of these patients by evaluating preoperative symptoms, fracture types, complication rates, and long-term outcomes. The evaluation of the results of the operations is based on the cohort of 149 patients. None of the patients with a 6-month follow-up who underwent surgery using the subcranial approach developed meningitis. Of the 9 patients (6 %) who required secondary surgery at the skull base, only 1 patient (0.7 %) required repair of a CSF leak. The most common long-term complication associated with secondary skull base surgery was mucocele formation (n = 6, 4 %). Fifteen patients developed enophthalmos (8.1 %) and eleven experienced diplopia (5.9 %). In conclusion, the subcranial approach is a safe surgical technique with a low incidence of long-term complications in comminuted fractures of the anterior skull base which is indicated for the rare severer cases.