Diagnosis and Treatment in frontobasal fractures

• Published in: HNO Vol. 71; no. 1; p. 35
• Main Authors: Sommer, F, Brand, M, Scheithauer, M O, Hoffmann, T K, Theodoraki, M-N, Weber, R
• Format: Journal Article
• Language: German
• Published: Germany 01.01.2023
• Subjects: Fractures, Bone - diagnostic imaging; Fractures, Bone - surgery; Humans; Neurosurgical Procedures - methods; Nose - surgery; Plastic Surgery Procedures; Skull Fractures - surgery; Tomography, X-Ray Computed; Orbital decompression; Frontobasal fractures; Rhinoliquorrhea; Skull base surgery; Duraplasty; Traumatic head injury; Cranial/Head imaging
• ISSN: 1433-0458
• DOI: 10.1007/s00106-022-01256-9

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.