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Frontobasilar Fractures

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Orbital Fractures

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Abstract

The frontobasilar region of the upper craniofacial skeleton is divided into two anatomical areas. The frontal area F is comprised of the anterior cranial vault. The basilar area B is comprised of the superior and lateral orbital walls, the orbital apex, and the ethmoidal labyrinth. The anterior cranial vault is twice as strong as the adjacent bone structures [1, 2].

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Notes

  1. 1.

    Differential diagnosis of cerebrospinal and lacrimal fluids is performed by measuring the glucose level. Glucose content over 30 mg/ml is typical of CSF.

  2. 2.

    Planned intraoperative use of a non-magnified image as a template during sinus obliteration/cranialization is the only indication for X-ray imaging of the frontal sinus (Fig. 8.7c, d).

  3. 3.

    A 57–157 kg/cm2 effort is needed to facture the frontal bone.

  4. 4.

    However, there have been anecdotal reports of the involvement of the trochlear notch in the supraorbital rim fracture line and entrapment of the superior oblique muscle tendon between the bone fragments, which resulted in development of clinical presentation of Brown’s syndrome in patients with orbital roof fractures [86].

  5. 5.

    The pathogenesis, clinical presentation, diagnosis, and treatment of this condition are described in detail in Sect. 8.5.1.2 and 8.5.3.

  6. 6.

    Nine cases have been reported in adults [71, 95, 97].

  7. 7.

    So is the syndrome: its incidence rate among patients with craniofacial trauma is 1.2 %.

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Authors and Affiliations

  1. Department of Ophthalmology, Saint Petersburg State Hospital No. 2, Saint-Petersburg, Russia

    Vadim P. Nikolaenko MD, PhD, DSc

  2. Department of Otolaryngology and Ophthalmology, Medical Faculty, Saint-Petersburg State University, Saint-Petersburg, Russia

    Vadim P. Nikolaenko MD, PhD, DSc

  3. Department of Ophthalmology, I.P. Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, Russia

    Yury S. Astakhov MD, PhD, DSc

  4. City Ophthalmologic Center at Saint Petersburg State Hospital No. 2, Saint-Petersburg, Russia

    Yury S. Astakhov MD, PhD, DSc

  5. Department of Neurosurgery, I.I. Mechnikov North-West State Medical University, Saint-Petersburg City Hospital No 2, Saint-Petersburg, Russia

    Yury A. Shulev MD, PhD

  6. ENT Department, First Pavlov State Medical University of Saint Petersburg, Saint-Petersburg, Russia

    Sergei A. Karpischenko MD

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  1. Vadim P. Nikolaenko MD, PhD, DSc
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Correspondence to Vadim P. Nikolaenko MD, PhD, DSc .

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  1. Ophthalmology, Saint-Petersburg State Hospital No. 2, Saint-Petersburg, Russia

    Vadim P. Nikolaenko

  2. Ophthalmology, I.P. Pavlov First Saint Petersburg State Medical University, Saint-Petersburg, Russia

    Yury S. Astakhov

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Nikolaenko, V.P., Astakhov, Y.S., Shulev, Y.A., Karpischenko, S.A. (2015). Frontobasilar Fractures. In: Nikolaenko, V., Astakhov, Y. (eds) Orbital Fractures. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46208-9_8

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