Sommer F, Brand M, Scheithauer M O, Hoffmann T K, Theodoraki M-N, Weber R
Universitätsklinik für Hals‑, Nasen‑, Ohrenheilkunde, Kopf- und Hals-Chirurgie, Universität Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
Hals-Nasen-Ohrenklinik des Städtischen Klinikums Karlsruhe, Karlsruhe, Deutschland.
HNO. 2023 Jan;71(1):35-47. doi: 10.1007/s00106-022-01256-9. Epub 2022 Dec 16.
Traumatic brain injury can result in frontobasal fractures (FBF). The goals of treatment for FBF are to eliminate primary morbidity and/or prevent secondary morbidity. Of particular importance in this regard is the proximity of important sensory organs for hearing, vision, smell, and taste, as well as their supplying nervous structures. Medical history, clinical findings, or CT scan are necessary and should lead to an individual evaluation. Depending on the severity of the fractures, the following disciplines may be involved in the treatment of FBF: neurosurgery, plastic surgery, oral and maxillofacial surgery, and/or otorhinolaryngology. Particularly less invasive endoscopic endonasal therapy is a specialty of otorhinolaryngologic surgeons and has not been widely established in other disciplines. The present work provides an overview of the current state of the art in terms of the following aspects, taking into account the current literature: anatomic principles, classification of fractures, diagnostics (in particular clinical examination, imaging, and laboratory chemistry tests), clinical symptoms, and treatment.
创伤性脑损伤可导致额基底骨折(FBF)。FBF的治疗目标是消除原发性疾病和/或预防继发性疾病。在这方面,重要的听觉、视觉、嗅觉和味觉感觉器官及其供应神经结构的临近程度尤为重要。病史、临床检查结果或CT扫描是必要的,并且应该进行个体评估。根据骨折的严重程度,以下学科可能参与FBF的治疗:神经外科、整形外科、口腔颌面外科和/或耳鼻喉科。特别地,侵入性较小的鼻内镜鼻内治疗是耳鼻喉科医生的专长,尚未在其他学科广泛开展。考虑到当前文献,本研究从以下几个方面对当前的技术水平进行了综述:解剖学原理、骨折分类、诊断(特别是临床检查、影像学和实验室化学检查)、临床症状和治疗。