创伤性前颅底骨折的急性期手术治疗(附134例报告)

Surgery for the treatment of traumatic fracture of the floor of the anterior cranial fossa in acute stage

目的探讨急性期修补前颅窝底骨折的手术方法。方法回顾性总结前颅底骨折病例134例,根据骨折波及范围,将其分为3种类型,根据不同类型总结其手术入路、修补方法、修复的效果。结果治愈125例,死亡9例。12例术后有轻微脑脊液鼻漏,经保守治疗后脑脊液鼻漏停止。随访47例,有3例脑脊液鼻漏复发,保守治疗后脑脊液鼻漏停止。结论硬脑膜破损的修补是颅底骨折修补的关键,对于严重筛窦骨折、骨质缺损的病例最佳的修补方法有待于进一步研究。

Objective To explore the operation methods for the treatment of traumatic fracture of the floor of the anterior cranial fossa in acute stage. Methods The clinical data of the 134 patients with the traumatic fracture of frontal skull base were collected. According to fracture scope, the cases were divided into 3 groups and analyzed based on operative approach, repair methods and results. Results One hundred twenty-five cases were healed and 9 cases died. Cerebrospinal rhinorrhea reoccurred in 12 cases after operation and were cured with conservation treatment. Follow up visit were performed on 47 cases and cerebrospinal rhinorrhea were reoccurred in 3 cases and were cured with conservation treatment. Conclusions The key of treatment of traumatic fracture of frontal skull base is to repair leakage of cerebral dura mater. The ideal repair method for serious fracture of ethmoidal sin and deossification needs further research.