A Clinical Study of 65 Cases in Basal Skull Fracture

ABSTRACT

65 consecutive patients with basal skull fracture admitted to Eul-Ji General Hospital, between March 1990 and March 1993 was carried out to study it's clinical and radiological presentations, complications, and outcomes. 1) Two thirds of the patients were between 20 and 40 years old and 82% were male. 2) 78% of the injuried were by traffic accidents and 17% were by fall down. 3) The outcomes of treatment were related to initial GCS(Glasgow coma scale) of the patients. 4) Clinical features were ear bleeding-54%, Racoon's eye-35%, hemotympaneum-32%, hearing loss-25%. 5) The combined lesions were skull fractures-43%, facial bone fractures-31%, subdural hematoma-19%, epidural hematoma-14%, and pneumocephalus-14%. 6) The combined cranial nerves injuried were facial nerve-32%, vestibulocochlear nerve-12%, oculomotor nerve-12%, abducens nerve-12%. 7) The location of basal skull fracture according to clinical feature and CT bone window were middle cranial fossa-54%, on anterior cranial fossa-22%, anterior and posterior cranial fossa-12%, posterior cranial fossa-2%. 8) Clinical features associated with types of petrous bone fractures were analyzed. 9) The time of onset and the degree of facial palsy had a influence on recovery of facial nerve function and the types of hearing loss had a role in recovery of hearing function. 10) CSF leakage were present in 16 cases and immediate type was more than delayed type. 11) Three patients(4.6%) developed meningitis, especially associated with CSF leakage and it's rate was higher when CSF leakage persisted over 1 week.