International Journal of Head and Neck Surgery

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VOLUME 14 , ISSUE 2 ( April-June, 2023 ) > List of Articles

Original Article

Skull Base Fracture: Management in the Acute Phase

Rasolonjatovo E Charles, Harimbonina Z Miantsa, Andrianaivo Radotina, Rakotovao T Ketsia, Ratovondrainy Willy, Rabarijaona Mamiarisoa, Andriamamonjy Clément

Keywords : Antibiotic prophylaxis, Cerebrospinal fluid leak, Posttraumatic hematoma, Skull base fracture

Citation Information : Charles RE, Miantsa HZ, Radotina A, Ketsia RT, Willy R, Mamiarisoa R, Clément A. Skull Base Fracture: Management in the Acute Phase. Int J Head Neck Surg 2023; 14 (2):17-20.

DOI: 10.5005/jp-journals-10001-1550

License: CC BY-NC 4.0

Published Online: 15-06-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Aim: Skull base fractures represent 7–16% of head injuries and mainly affect the active and young population. The aim of this article is to report the epidemiological, clinical, anatomopathological, and therapeutic aspects of skull base fracture in adults treated in the neurosurgery department of our hospital. Materials and methods: This was a retrospective, descriptive study of skull base fractures hospitalized from 1st January 2019 to 31st December 2021. The epidemiological, clinical, anatomopathological and therapeutic aspects of skull base fracture were analyzed. Results: We collected 168 cases of skull base fracture. Young male adults were predominantly affected, with a mean age of 33.69 ± 13.70 years. The main cause was road traffic accidents (79.8%). The Glasgow score was 14 and 15 in 95.8% of cases. Around 17% of patients had cerebrospinal fluid (CSF) rhinorrhea and 7.7% had CSF otorrhea. All patients had undergone a brain scan. The fracture was located at the anterior skull base in 102 cases (60.7%) and at the temporal bone in 65 cases. Antibiotic prophylaxis was systematically prescribed for all patients. Pneumococcal vaccination was performed in 19.6% of patients. The posttraumatic hematoma was the main indication for surgical treatment. Duraplasty was indicated because of persistent rhinorrhea. There were two cases of bacterial meningitis among the CSF leaks. Two cases of death were recorded (1.2%), the cause of which was sepsis from bacterial meningitis and cerebral involvement following diffuse axonal injury. Conclusion: The results of medical and surgical management of skull base fracture in our context were favorable. Prevention of infectious risks, including vaccination, should be mandatory.

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