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Subcranial craniotomy approach for frontobasal fracture correction
Ulla Perheentupa1, Antti A Mäkitie2, Ilpo Kinnunen1
1Department of Otolaryngology - Head and Neck Surgery (Head: Professor Reidar Grénman), Turku University Hospital and University of Turku, P.O. Box 52, FI - 20521 Turku, Finland.
Summary
The subcranial approach effectively manages all frontobasilar fractures, including complex cases. This technique demonstrated a low complication rate in a study of 48 patients.
Area of Science:
- Neurosurgery
- Craniofacial Surgery
- Trauma Surgery
Background:
- Frontobasilar fractures present complex management challenges.
- The subcranial approach is a surgical technique for accessing the anterior cranial base.
Purpose of the Study:
- To evaluate frontobasilar fracture types.
- To assess patient outcomes following management with the subcranial approach.
Main Methods:
- Retrospective analysis of 48 patients undergoing subcranial approach for frontal base fracture.
- Data collected from April 1996 to April 2011 at a tertiary care academic hospital.
Main Results:
- 33% of patients had fractures involving all frontobasilar types (I-IV).
- 56% had brain damage at presentation; 40% had synchronous trauma.
- Low incidence of cerebrospinal fluid (CSF) fistula (2 patients) and no postoperative meningitis.
- 35% experienced permanent neurological deficits post-injury.
Conclusions:
- The subcranial approach is successful for all frontobasilar fractures, including complex ones.
- The technique offers a reasonably low complication rate.
- Recommended as the preferred method for multiple and complicated frontal base fractures.
