Sphenoid fractures: prevalence, sites, and significance

The computed tomographic (CT) scans of the head of 490 blunt trauma victims were reviewed to establish the frequency of sphenoid fractures. There were 111 patients with craniofacial fractures, 78 of whom had fractures of the sphenoid bone. In 51 of the 78 patients these were associated with complex facial fractures, and in the 27 remaining patients they represented primarily fractures of the skull base. The number of sphenoid fractures not only exceeded those that involved the other bones of the base of the skull, including the temporal bone, but also exceeded the number of fractures of the cranial vault that could be identified with CT. All available charts were reviewed for the patients with sphenoid fractures in order to determine the presence of potentially related injuries. In 21 patients there were complications that included damage to the internal carotid artery, cerebrospinal fluid rhinorrhea, optic nerve damage, superior orbital fissure syndrome, and posttraumatic diabetes insipidus.