Reconstruction of Anterior Skull Base Fracture Using Autologous Fractured Fragments: A Simple Stitching-Up Technique

Area of Science:

• Neurosurgery
• Trauma Surgery
• Craniofacial Reconstruction

Background:

• Displaced anterior cranial base fractures can lead to cerebrospinal fluid (CSF) rhinorrhea and enophthalmos.
• Current management requires effective reconstruction to prevent complications.

Purpose of the Study:

• To introduce and evaluate a novel reconstruction technique for displaced anterior cranial base fractures.
• To assess the efficacy of direct dural repair and autologous fragment fixation in preventing CSF leakage and enophthalmos.

Main Methods:

• A stitching-up technique involving frontal craniotomy and direct dural repair was employed.
• Autologous fractured bone fragments were repositioned and fixed using a silk-tying method.
• No lumbar drains were used in the surgical procedures.

Main Results:

• Five male patients with displaced anterior cranial base fractures, primarily involving the orbital roof and ethmoid bone, were treated.
• Dural lacerations were repaired with artificial dura or pericranial grafts.
• All patients experienced uneventful recovery with successful anterior cranial fossa reconstruction and no instances of CSF leakage or enophthalmos.

Conclusions:

• Direct dural repair combined with autologous bone fragment reconstruction is an effective method.
• This technique successfully prevents cerebrospinal fluid leakage and enophthalmos in displaced anterior cranial base fractures.