[The present state of frontal skull-base surgery (author's transl)]

Abstract

Our experience in 125 cases of traumatic frontal skull-base and mid-face lesions is discussed. 88 patients were operated on immediately after injury whereas 37 were operated on when the presented with complications due to the trauma some time after the injury. Small aeroceles seen on the computer tomogram are a definite and accurate sign of a dural rupture. The indications for an exploration of the frontal skull-base should be rather liberal since most dura lesions are difficult to verify. The current surgical techniques to repair the posterior wall of the frontal sinus and the cribriform plate are discussed in detail. The subfrontal transethmoidal approach allows the dura defect to be repaired at the time the sinus disease and facial fractures are surgically treated, and is preferred to the transfrontal neurosurgical approach where a much higher incidence of complications in the sinuses is found.