The surgical one-stage management of fronto-basal fractures

We present a retrospective review of 38 trauma cases that underwent the subcranial approach to the anterior skull base and facial skeleton during a period of 5 years. Patients were retrospectively reviewed and tabulated for age, sex, and indications for procedure. Special emphasis was placed on early outcome and complications. Preoperative radiologie evaluation with a new technique-the 30-degree tilt axial CT scan-will be presented. Complications included 1 case with postoperative CSF leakage and pneumocephalus necessitating two secondary operations. One patient had transient pneumocephalus that resolved spontaneously. Bone-flap infection occurred in 1 patient. Enophthalmos and telecanthus occurred in 4 patients each. The most common postoperative complication was anosmia, which occurred in 13 patients. It is concluded that the subcranial approach offers a favorable exposure of the critical zones of the anterior skull base, thus facilitating reduction and reconstruction.