Advertisement

Trauma Traumatic Injuries of the Skull Base

  • Alexander KönigEmail author
  • Sebastian Ranguis
Chapter

Abstract

The main indication for a surgical procedure after trauma in the area of the anterior cranial fossa (frontobasal injury) is a persisting rhinorrhoea of CSF with the potential of secondary meningitis. At the middle fossa and lateral skull base, indication for surgery is given in cases of epidural haematoma, rhinorrhoea or otorrhoea or injury of the facial nerve. In the posterior fossa, mainly epidural haematomas require surgery, whereupon the surgeon has to keep in mind that the haemorrhage can have its origin from an injury of a venous dural sinus. Significant instabilities of the craniocervical junction after trauma often require occipitocervical fusion.

Supplementary material

Video 4.1

(MP4 213052 kb)

References

  1. 1.
    Bernal-Sprekelsen M, Rioja E, Enseñat J, Enriquez K, Viscovich L, Agredo-Lemos FE, Alobid I. Management of anterior skull base defect depending on its size and location. Biomed Res Int. 2014;2014:346873. https://doi.org/10.1155/2014/346873. Epub 2014 May 7.CrossRefGoogle Scholar
  2. 2.
    Biron VL, Gross M, Broad R, Seikaly H, Wright ED. Radial forearm free flap with titanium mesh sandwich reconstruction in complex anterior skull base defects. J Craniofac Surg. 2012;23(6):1763–5.CrossRefGoogle Scholar
  3. 3.
    Peng CW, Chou BT, Bendo JA, Spivak JM. Vertebral artery injury in cervical spine surgery: anatomical considerations, management, and preventive measures. Spine J. 2009;9:70–6.CrossRefGoogle Scholar
  4. 4.
    Chin D, Harvey RJ. Endoscopic reconstruction of frontal, cribiform and ethmoid skull base defects. Adv Otorhinolaryngol. 2013;74:104–18.PubMedGoogle Scholar
  5. 5.
    Eloy JA, Patel SK, Shukla PA, Smith ML, Choudhry OJ, Liu JK. Triple-layer reconstruction technique for large cribriform defects after endoscopic endonasal resection of anterior skull base tumors. Int Forum Allergy Rhinol. 2013;3(3):204–11.CrossRefGoogle Scholar
  6. 6.
    Giovannetti F, Ruggeri A, Buonaccorsi S, Pichierri A, Valentini V. Endoscopic endonasal approaches for cerebrospinal fluid leaks repair. J Craniofac Surg. 2013;24(2):548–53.CrossRefGoogle Scholar
  7. 7.
    Hausamen JE, Schmidseder R Beteiligung der vorderen Schädelbasis bei Frakturen des Mittelgesichts. In: Schuchardt K (editor) Fortschr Kiefer GesichtsChir, Bd XIX. Stuttgart/New York: Thieme; 1975. p. 134–6.Google Scholar
  8. 8.
    Hausamen JE, Machtens E, Reuther J, Eufinger H, Kübler A, Schliephake H. Mund-, Kiefer- und Gesichtschirurgie. Operationslehre und –atlas. Berlin Heidelberg: Springer; 2012. p. 240–1.CrossRefGoogle Scholar
  9. 9.
    House JW, Brackmann DE. Facial nerve grading system. Otolaryngol Head Neck Surg. 1985;93:146–7.CrossRefGoogle Scholar
  10. 10.
    Josten C. Halswirbelsäule. In: Bühren B, Josten C, editors. Chirurgie der verletzten Wirbelsäule. Berlin Heidelberg: Springer; 2013. p. 137–74.Google Scholar
  11. 11.
    König SA, Ranguis S, Gramlich V, Spetzger U. Reconstruction of the anterior skull base after major trauma or extensive tumour resection. Acta Neurochir. 2015;157:139–44.CrossRefGoogle Scholar
  12. 12.
    Mielke D, Mayfrank L, Psychogios MN, Rohde V. The anterior interhemispheric approach – a safe and effective approach to anterior skull base lesions. Acta Neurochir. 2014;156(4):689–96.CrossRefGoogle Scholar
  13. 13.
    Oberascher G. Diagnostik der Rhinoliquorrhoe. Eur Arch Otorhinolaryngol Suppl. 1993;1:485–92.Google Scholar
  14. 14.
    Reiß M. Facharztwissen HNO-Heilkunde. Berlin Heidelberg: Springer; 2009. p. 910–4.CrossRefGoogle Scholar
  15. 15.
    Wolf G, Greistorfer K, Stammberger H. Der endoskopische Nachweis von Liquorfisteln mittels der Floureszeintechnik. Ein Erfahrungsbericht über 925 Fälle. Laryngorhinootologie. 1997;76(10):588–94.CrossRefGoogle Scholar
  16. 16.
    Yeom JS, Buchowski JM, Kim HJ, Chang BS, Lee CK, Riew KD. Risk of vertebral artery injury: comparison between C1-C2 transarticular and C2 pedicle screws. Spine J. 2013;13(7):775–85.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Neurochirurgische Klinik, Klinikum KarlsruheKarlsruheGermany

Personalised recommendations