[Indication and treatment of frontobasal rhinoliquorrhoea from the ent-surgical and neurosurgical point of view (author's transl)]

Abstract

This paper deals with some special questions based on joint neuro-rhinosurgical diagnostic and treatment of frontobasal injuries with rhinoliquorrhoea. The indications of the rhinosurgical transfronto-orbital approach with debridement of paranasal sinuses in the same stage are defined. Detailed technical instructions are given for treatment of "midline fractures". The transfrontal intradural approach of the neurosurgeon should be prefered: 1. If there is rhinoliquorrhoea combined with an extensive fracture of anterior skull base. 2. In cases of frontobasal liquor fistual--no matter of localisation and extension--with increasing spaceoccupation should the intracranial decompression be combined with duraplasty. Cerebral lesions with no progressive intracranial pressure should be treated first of all conservatively. The operative treatment of paranasal sinuses is not necessary in every case after transfrontal intradural surgery. X-ray controls have shown the spontaneous healing.