Vranković D, Glavina K
Section of Neurosurgery, General Hospital Osijek, Yugoslavia.
Neurochirurgia (Stuttg). 1989 Jul;32(4):110-5. doi: 10.1055/s-2008-1054016.
Traumatic lesions of the anterior cranial fossa (ACF) with comminuted depressed fractures and with tears of dura require operative management. In reports, the results of surgical treatment (repairing dural defects only) are not quite satisfactory. The cause of recurrent cerebrospinal fluid (CSF) rhinorrhea and/or meningitis in some cases is the neglect in managing the bone defects. Being aware of the importance of the bony part of the ACF, in isolating the intracranial contents from the nasal and/or sinusal cavities, the covering of the midline bone defects on the floor of the ACF is also strongly indicated. We treated four patients with acrylic material and one of them had recurrence of meningitis. Four years ago we started to cover the ACF bone defects using the plates and chips of autologous cancellous bone. Out of a group of 45 patients, 14 were treated closing the dura wounds and obliterating the bone defects. Five of them died of primary cerebral injuries; and in 9 patients (5 operated in acute stage and 4 in chronic stage) the results were excellent.
前颅窝（ACF）伴有粉碎性凹陷骨折和硬脑膜撕裂的创伤性损伤需要手术治疗。在报告中，手术治疗（仅修复硬脑膜缺损）的结果并不十分令人满意。某些病例中脑脊液（CSF）鼻漏和/或脑膜炎复发的原因是对骨缺损处理的忽视。意识到前颅窝骨部分在将颅内内容物与鼻腔和/或鼻窦腔隔离方面的重要性，强烈建议对前颅窝底部的中线骨缺损进行覆盖。我们用丙烯酸材料治疗了4例患者，其中1例发生了脑膜炎复发。四年前，我们开始使用自体松质骨板和骨块覆盖前颅窝骨缺损。在一组45例患者中，14例接受了硬脑膜伤口闭合和骨缺损闭塞治疗。其中5例死于原发性脑损伤；9例患者（5例在急性期手术，4例在慢性期手术）效果极佳。
