[Fractures with loss of substance of the middle and upper third of the face: nosographic classification, surgical indications and the prevention of meningeal infections with the new antibiotic, cefuroxime].

Reference is made to considerable personal experience acquired in the treatment of craniofacial fractures, particularly those affecting the upper third of the face. An account is given of the anatomical and surgical features of the naso-ethmoid-frontal and temporo-orbito-sphenoid areas--now recognised as within the domain of maxillofacial surgery--and their symptomatologies. Particular attention is directed to the question of liquorrhoea and the possibility of ascendent infections of the meninges. Reduction is favoured with respect to the former, since forward and upward repositioning often leads to the regression of ethmoidal liquorrhoea. Exclusion of the frontal sinus is regarded as a "categorical imperative" as far as meningeal infection is concerned, and support is also given for its prevention with antibiotics. A personal preference is expressed for cefuroxim, a new antibiotic with particular potency and marked diffusibility within the cerebrospinal fluid.