[Fronto- and laterobasal injuries in childhood and adolescence]

Within a period of 5 years, the author treated, among 106 children and adolescents up to 15 years of age with craniocerebral injuries, 12 who had frontobasal and laterobasal lesions. These were extended comminuted fractures, impression fractures, linear fractures (fissures), ethmoidal fractures, as well as a petrosal bone fracture. Principal signs were rhinoliquorrhoea or otoliquorrhoea, traumatic disturbances of consciousness and intracranial air accumulations. Less frequently, traumatic shock, signs of CSF infection and concomitant eye injuries were seen. Surgical care (treatment of the dural defect and plastic occlusion by means of Lyodura, galea-periosteal flap or fascia lata) was mostly effected transfrontally, in two cases transethmoidally and in one case with combined technique. In two cases, primary frontal decomminution had to be followed by a transethmoidal second intervention to close a lesion of the dura in the region of the sphenoid sinus. Surgery was carried out as an immediate operation in case of open injuries and in massive liquorrhoea if the general condition of the patient was good. In all other cases, operation was delayed until the second week after injury.