Results of Surgical Management of Anterior Cranial Fossa Fractures

Abstract

Results of Surgical Management of Anterior Cranial Fossa Fractures

Alongkorn Jaiimsin MD

Department of Surgery, BMA Medical College and Vajira Hospital

Objective: To determine and review the results of surgical management of anterior cranial fossa fractures repaired by patients' pericranium and temporalis muscle.

Study design: Descriptive study.

Subjects: A total of 50 patients with anterior cranial fossa fractures operated in Phranakorn Sri Ayutthaya Hospital and BMA Medical College and Vajira Hospital from April 2000 to September 2006.

Methods: Data from hospital records, operative notes, radiography of skull and CT scan of brain and skull were reviewd and analysed.

Main outcome measures: Operative time, duration of hospital stay, and complications of the operation.

Results: Mean age of the patients was 27.6 ± 5.2 years (17-49 years), 48 (96.0%) were male and 2 (4.0%) were females. The most common cause was motorcycle accident (80.0%); 30 patients (60.0%) were categorized according to the Glasgow coma scale as mild head injury, while 12 patients (24.0%) and 8 patients (16.0%) were categorized as moderate and severe head injury. In the early phase of this study, 12 patients (24.0%) were operated by a single surgical team with 330.4 ± 20.6 minutes of operative time, while the remaining 38 patients (76.0%) were operated by 2 surgical teams, the anterior cranial fossa reconstruction team and the bony fragment assemble team, with 260.1 ± 13.3 minutes of operative time. The average duration of hospital stay was 19.2 ± 4.9 days (7-35 days) No one die after surgery. Postoperative complications were cerebrospinal leakage (2.0%), meningitis (14.0%) and skull deformitiy (8.0%).

Conclusion: The surgical management of anterior cranial fossa fractures using patient's own pericranium and temporalis muscle was simple, safe, inexpensive and with only few complications.

Vajira Med J 2009 ; 53 : 143-151