Management of severe frontobasilar skull fractures

Immediate reconstruction of severely comminuted frontobasilar skull fractures involving the frontal sinus can be accomplished safely if the sinus is cranialized and the floor of the anterior cranial fossa is totally reconstructed. Operative time can be reduced if the pieces of the frontal bone are reassembled and stabilized with rigid fixation devices out of the surgical field and thus made ready for reinsertion as a single unit after any necessary neurosurgical procedures are completed. Immediate reconstruction provides postoperative protection for the brain and eliminates the need to return the patient to the operating room for cranioplasty at a later date.