Clinical Analysis of Basal Skull Fracture / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Basal skull fractures are different from cranial vault fractures in several aspects. These fractures are difficult to diagnose by ordinary X-ray, routine head CT and are frequently inferred from clinical signs. It involves more commonly the cranial nerves, makes fistulae of cerebrospinal fluid (CSF) and lead to central nervous system infections. Despite the clinical significance of basal skull fracture in otorhinolaryngology, there have been only a few clinical studies. So we began this research for better treatment of basal skull fracture (BSF). MATERIALS AND METHOD: The authors analyzed 100 cases of basal skull fracture treated in the department of neurosurgery, from January 1998 to December 2000. We reviewed the clinical features, radiologic findings, and rate of delayed diagnosis. RESULTS: The basal skull fractures were more common in men than women. In the decreasing order of cause in basal skull fractures were traffic accidents (64%), fall down and assault. Clinical features were nasal bleeding (42%), ear bleeding (41%) and hearing loss (36%). Most of CSF leakages were noted within 24 hours after injury and had ceased by conservative management. The degree of facial palsy had an influence on the recovery of facial nerve function. The types of hearing loss had a role in the recovery of hearing. Six cases (6%) were delayed in the diagnosis of BSF. CONCLUSION: In the BSF patient's treatment, many parts needed otorhinolaryngological treatment. But in the patient's treatment, otorhinolaryngological problems had been ignored by the neurosurgical concerns. From the otorhinolaryngoloical aspect, BSF patients should be given an active treatment.