Skull base fractures: An institutional experience with review of literature

Abstract

Fractures of the skull base are relatively common. They have been reported to occur in 3.5–24.0 percent of head injury patients. This wide variation results from differences in studied patient populations and from difficulty of obtaining radiographic verifications of the fracture.¹ The Traumatic Coma Data Bank in a prospective series of severe head injury reported that 25% had basilar skull fractures.² In this paper we analyze the various types of fractures and their management.

Keywords

Fracture - Skull base - Trauma

• References

• 1 Willberry J., Chu D.A.. Management of head injury. The skull and meninges. Neurosurg Clin N Am 1991; 02 (01) 341-350
• 2 Eisenberg H.M., Gary H.B., Aldrich E.F.. et al Initial CT findings in 753 patients with severe head injury: a report from INH traumatic coma data bank. J Neurosurg 1990; 73 (05) 68-81
• 3 Thibault L.E., Gennerelli T.A.. Biomechanics and Craniocerebral Trauma: Central Nervous System Trauma Research Status Report – 1985. 1985. National Institute of Neurological and Communicative Disorders and Stroke. NIH; Bethesda: 379-389
• 4 Park J.I., Strelzow V.V., Freidman W.H.. Current management of CSF fluid rhinorrhoea. Larynoscope 1983; 93: 1294-1296
• 5 Spetzler R.F., Zabramski J.M.. Cerebrospinal fluid fistula. Contemp Neurosurg 1986; 08: 1
• 6 Samii M., Tatagiba M.. Skull base trauma: diagnosis and management. Neurol Res 2002; Mar 24 (02) 147-156
• 7 Abuabara A.. Cerebrospinal fluid rhinorrhea: diagnosis and management. Med Oral Patol Oral Cir Bucal 2007; 12 (05) 397-400 1
• 8 Rovit RL, Mumti R. Injuries of the cranial nerves. In: Cooper PR, ed. Head Injury. 3rd ed.; 1993:183e202.
• 9 Aarabi B., M.Queen J.D.. Traumatic internal carotid artery. Occlusion at the base of the skull. Surg Neurol 1978; 10: 233-236
• 10 Conor S.E., Tan G., Fernando R., Chaudhury N.. Computed tomography pseudo fractures of the mid face and skull base. Clin Radiol 2005; Dec 60 (12) 1268-1279
• 11 Girish M., Amish H., Dugar Motul. et al Role of 3D CT in the evaluation of temporal bone. Radiographics 2006; 26: S117-S132
• 12 Ringl H., Schernthaner R.E., Schueller G.. et al The skull unfolded: a cranial CT visualization algorithm for fast and easy detection of skull fractures. Radiology 2010; 255: 553-562
• 13 Schuknecht B., Graetz K.. Radiologic assessment of maxillofacial, mandibular, and skull base trauma. Eur Radiol 2005; Mar 15 (03) 560-568
• 14 Kienstra M.A., Van Loveren H.. Anterior skull base fractures. Facial Plast Surg 2005; Aug 21 (03) 180-186
• 15 Yilmazlar S., Arslan E., Kocaeli H., Dogan S., Aksoy K.. Cerebrospinal fluid leakage complicating skull base fractures: analysis of 81 cases. Neurosurg Rev. 2006; 29 (01) 64-71
• 16 Ishman S.L., Friedland D.R.. Temporal bone fractures: Traditional classification and clinical relevance. Laryngoscope 2004; Oct 114 (10) 1734-1741
• 17 Canon C.R., Jahrsdocrfer R.A.. Temporal bone fractures: review of 90 cases. Arch Otolaryngol 1983; 109: 285-288
• 18 Ghorayeb B.Y., Yeakley J.W.. Temporal bone fractures: longitudinal or oblique? The case of oblique temporal bone fractures. Laryngoscope 1992; 102: 129-134
• 19 Fisch U.. Facial paralysis in fractures of petrous bone. Laryngoscope 1974; 84: 2141-2144
• 20 Steward C.L., Bradley W.K.. Radiographic classification of temporal bone fractures. Clinical predictability using a new system. Arch Otolaryngol Head Neck Surg 2006; 132: 1300-1304
• 21 June M.U., Lindell R.G., Jeffrey E.G.. Sphenoid fractures: prevalence, sites and significance. Radiology 1990; 175: 175-180
• 22 Joslyn J.N., Mirvis S.E., Markowitz B.. Complex fractures of the clivus: diagnosis with CT and clinical outcome in 11 patients. Radiology 1988; 166: 817-821
• 23 Anderson P.A., Moutesano P.X.. Morphology and treatment of occipital condyle fractures. Spine 1988; 13: 731-736
• 24 Villalobos T., Arango C., Kubilis P., Rathore M.. Antibiotic prophylaxis after basilar skull fractures: a meta-analysis. Clin Infect Dis 1998; Aug 27 (02) 364-369
• 25 Brodie H.A.. Prophylactic antibiotics for posttraumatic cerebrospinal fluid fistulae. A meta-analysis. Arch Otolaryngol Head Neck Surg 1997; Jul 123 (07) 749-752
• 26 Bell R.B., Derks E.J., Homer L., Potter B.E.. Management of cerebrospinal fluid leak associated with craniomaxillofacial trauma. J Oral Maxillofac Surg 2004; 62 (06) 676-684
• 27 Hughes R.G.M., Jones N.S., Robertson I.J.A.. The endoscopic treatment of CSF rhinorrhoea. The Nottingham experience. J Laryngol Otol 1997; 111: 125-128
• 28 Wang B.H., Robertson B.C., Girotto J.A.. et al Traumatic optic neuropathy: a review of 61 patients. Plast Reconstr Surg 2001; 107 (07) 1655-1664
• 29 Hickman M.J., Cote D.N.. Temporal bone fractures. J La State Med Soc 1995; 147: 527-530
• 30 Brodie H.A., Thompson T.C.. Management of complications from 820 temporal bone fractures. Am J Otol 1997; 18: 188-197
• 31 Coker N.J.. Management of traumatic injuries to the facial nerve. Otolaryngol Clin North Am 1991; 24: 215-227
• 32 Menku A., Koc R.K., Tucer B.. et al Clivus fractures: clinical presentations and courses. Neurosurg Rev 2004; Jul 27 (03) 194-198