Kessler P, Hardt N
Klinik für Mund-, Kiefer- und Gesichschirurgie, Kantonsspital Luzern.
Mund Kiefer Gesichtschir. 1998 Jul;2(4):202-8. doi: 10.1007/s100060050059.
Injuries of the nasoethmoid-orbital (NEO) region are associated with midfacial fractures or fractures of the frontobase in over 90% of all cases. In up to 70% fractures of the skull base run through the roof of the ethmoidal bone or the lamina cribrosa. There are different surgical approaches for the treatment of these complex fractures. Between 1990 and 1997 50 patients with midfacial fractures in association with NEO fractures were treated in the Klinik für Mund-, Kiefer- und Gesichtschirurgie, Kantonsspital Luzern, Switzerland. Of these, 25 had suffered midfacial fractures combined with fractures of the nasoethmoid-orbital and frontobasal region and were treated via a transcranial approach. The other 25 patients with midfacial and NEO fractures without involvement of the frontobasis were managed by subcranial incisions. A total of 47 patients were followed up for up to 4 years. The results were reevaluated retrospectively. There was no case of secondary liquorrhea, intracranial or ethmoidal infection. Our therapeutic concept of transcranial and subcranial management of NEO fractures in combination with frontobasal and midfacial fractures is demonstrated.
在所有病例中，超过90%的鼻筛窦-眶部（NEO）区域损伤与面中部骨折或额底骨折相关。高达70%的颅底骨折穿过筛骨顶板或筛板。对于这些复杂骨折有不同的手术入路。1990年至1997年期间，瑞士卢塞恩州立医院口腔颌面外科对50例伴有NEO骨折的面中部骨折患者进行了治疗。其中，25例为面中部骨折合并鼻筛窦-眶部和额底区域骨折，采用经颅入路进行治疗。另外25例面中部和NEO骨折但未累及额底的患者采用颅下入路进行处理。共有47例患者接受了长达4年的随访。对结果进行了回顾性重新评估。无继发性脑脊液漏、颅内或筛窦感染病例。展示了我们对NEO骨折合并额底和面中部骨折采用经颅和颅下处理的治疗理念。
