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创伤性额窦骨折的治疗:来自高创伤中心的经验

Traumatic Frontal Sinus Fractures Management: Experience from High-Trauma Centre.

作者信息

Al-Shami Hieder, Alnemare Ahmad K, Mahfoz Turki Bin, Salah Ahmed M

机构信息

Department of Neurosurgery, Al-Ahly Bank Hospital, Cairo, Egypt.

Department of Otolaryngology, College of Medicine, Majmaah University, Majmaah, Saudi Arabia.

出版信息

Korean J Neurotrauma. 2021 Mar 18;17(1):15-24. doi: 10.13004/kjnt.2021.17.e3. eCollection 2021 Apr.

Abstract

OBJECTIVE

Analysis of our traumatic brain injury data, reviewing current literatures and assessing planning valuable decision making in frontal sinus fracture for young neurosurgeons.

METHODS

Hospital data base for head trauma was retrieved after board permission for retrospective analysis of cases admitted from 2010-2020. Patients with frontal sinus fractures and head trauma were identified according to a flow chart. Variables of the study included patients' demographics, mechanism of injury, incidence of cerebrospinal fluid (CSF) leakage, types of associated injuries, imaging findings and operative techniques.

RESULTS

Three-hundred eighty two patients were eligible to be screened in our study and represented the sample size under investigations in the following sections, 206 (53.9%) of patients were treated conservatively while 176 patients (46.1%) were identified as having an indication for surgical intervention. Eighty-four percent of patients were males. The mean age was 36.2±9.4 years (14-86 years). Depressed skull fracture was commonly associated injury (17.61%). Leakage of CSF was found in 32.95% of patients.

CONCLUSION

Frontal sinus fracture is not an easy scenario. It harbors many proportions and deliver many varieties in which, deep understanding of anatomy, naso-frontal outflow tract status, CSF leakage and neurological injury are of important points in decision. Our institutional algorithm provide rapid, accessible and applicable treatment protocol for resident and young neurosurgeons which minimizes consultations of other specialties.

摘要

目的

分析我们的创伤性脑损伤数据,回顾当前文献,并评估为年轻神经外科医生在额窦骨折中进行有价值决策的规划。

方法

在获得委员会批准后,检索医院头部创伤数据库,对2010年至2020年收治的病例进行回顾性分析。根据流程图确定额窦骨折和头部创伤患者。研究变量包括患者的人口统计学特征、损伤机制、脑脊液(CSF)漏的发生率、相关损伤类型、影像学表现和手术技术。

结果

382例患者符合纳入本研究的筛选标准,代表了以下各节中调查的样本量,206例(53.9%)患者接受保守治疗,176例(46.1%)患者被确定有手术干预指征。84%的患者为男性。平均年龄为36.2±9.4岁(14 - 86岁)。凹陷性颅骨骨折是常见的相关损伤(17.61%)。32.95%的患者发现脑脊液漏。

结论

额窦骨折情况并不简单。它有多种情况,涉及诸多方面,其中对解剖结构、鼻额流出道状况、脑脊液漏和神经损伤的深入了解是决策的要点。我们机构的算法为住院医生和年轻神经外科医生提供了快速、可获取且适用的治疗方案,最大限度地减少了其他专科的会诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a9b6/8093022/59b2f4faf07f/kjn-17-15-g001.jpg

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