Retrospective analysis of surgical treatment of frontobasal fractures with the new bernese skull base fracture score

Christian Schedeit , Ioanna Kalaitsidou , Nathalie Schedeit , Bradley Aebi , Kotaro Sato , Benoît Schaller
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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.
应用新bernese颅底骨折评分对额基底骨折手术治疗的回顾性分析
本研究的目的是评估颅下入路治疗前颅底骨折的成功率和有效性,并与文献报道的结果进行比较。此外,将使用新的Bernese颅底评分对该方法进行临床推荐。2002年至2018年,我科共收治185例严重粉碎性骨折或脑脊液(CSF)泄漏的成人外伤后开放性颅底手术患者。我们通过评估术前症状、骨折类型、并发症发生率和长期预后对所有患者进行回顾性分析。手术结果的评估是基于149例患者的队列。在6个月的随访中,接受颅下入路手术的患者无一发生脑膜炎。在9例(6%)需要颅底二次手术的患者中,只有1例(0.7%)需要修复脑脊液泄漏。与二次颅底手术相关的最常见的长期并发症是粘液囊肿形成(n = 6,4 %)。15例出现眼内陷(8.1%),11例出现复视(5.9%)。综上所述,颅下入路是治疗前颅底粉碎性骨折的一种安全、长期并发症发生率低的手术方法,适用于罕见的重症病例。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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