Lorenz K J, Maier H, Mauer U M
Klinik für Hals-Nasen-Ohrenheilkunde, Kopf-Halschirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Deutschland.
HNO. 2011 Aug;59(8):791-9. doi: 10.1007/s00106-011-2338-4.
The role of ENT surgery in the management of anterior skull base defects has become increasingly important in recent years. Transnasal endoscopic surgical techniques and intraoperative navigation enable a minimally invasive approach in a large proportion of patients, thus helping to avoid morbidity typically associated with neurosurgical subfrontal approaches. Whereas traffic accidents and sport injuries are the main causes of anterior skull base trauma in the civilian setting, penetrating injuries caused by gunshots and improvised explosive devices (IEDs) play an increasing role in the military arena and terroristic attacks. Minor injuries to the anterior skull base are usually managed by ENT surgeons. Major injuries, involving the midface or neurocranium, require an interdisciplinary approach including maxillofacial surgeons and neurosurgeons. A centre for head and neck medicine and surgery is an ideal setting for such interdisciplinary teams to provide appropriate care for patients with complex skull base trauma in cooperation with ophthalmologists and interventional neuoradiologists. The present article describes concepts for the treatment of anterior skull base trauma established at the head, neck and skull base center at the Ulm military hospital in Germany.
近年来，耳鼻喉科手术在处理前颅底缺损方面的作用变得越来越重要。经鼻内镜手术技术和术中导航使得大部分患者能够采用微创方法，从而有助于避免通常与神经外科额下入路相关的并发症。在 civilian 环境中，交通事故和运动损伤是前颅底创伤的主要原因，而在军事领域和恐怖袭击中，枪伤和简易爆炸装置（IED）造成的穿透伤作用日益凸显。前颅底的轻伤通常由耳鼻喉科医生处理。涉及中面部或神经颅骨的重伤则需要包括颌面外科医生和神经外科医生在内的多学科方法。头颈医学与外科中心是此类多学科团队的理想场所，可与眼科医生和介入神经放射科医生合作，为复杂颅底创伤患者提供适当的护理。本文介绍了德国乌尔姆军事医院头颈颅底中心确立的前颅底创伤治疗理念。
