A surgical method for treating anterior skull base injuries

Skull base surgery was performed on 18 patients with anterior skull base in juries. The operative technique consisted of opening the operative field in the anterior skull base via a coronal incision and a frontal craniotomy, d ebridement of the anterior skull base including the injured dura mater, per forming drainage from the anterior skull base to the nasal cavity by ethmoi dectomy, and reconstructing the resulting dural and anterior skull base def ect using bilateral temporal musculo-pericranial flaps and a bone graft. Seventeen of the 18 patients recovered without any complications, although epidural abscesses in the anterior skull base had been present in four pati ents at the time of the operation. Only one patient developed an epidural a bscess in the anterior skull base after the operation. None of the patients developed any other complications including meningitis, recurrent liquorrh oea or cerebral herniation. Satisfactory aesthetic results were achieved in 16 of the 18 patients. In one patient, uneven deformity of the forehead, w hich was caused by the partial sequestration of the frontal bone due to pos toperative infection, was observed. In another patient, a depressed deformi ty of the forehead, which was caused by the partial loss of the frontalis m uscle following the use of the frontal musculo-pericranial flap instead of a temporal musculo-pericranial flap, was observed. Anterior skull base reco nstruction using bilateral temporal musculo-pericranial flaps provides exce llent results in terms of patient recovery and aesthetics.