دورية أكاديمية
Anterior Cranial Base Reconstruction in Complex Craniomaxillofacial Trauma: An Algorithmic Approach and Single-Surgeon's Experience
| العنوان: | Anterior Cranial Base Reconstruction in Complex Craniomaxillofacial Trauma: An Algorithmic Approach and Single-Surgeon's Experience |
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| المؤلفون: | Sameer Shakir, Elizabeth B. Card, Rotem Kimia, Matthew R. Greives, Phuong D. Nguyen |
| المصدر: | Archives of Plastic Surgery, Vol 49, Iss 02, Pp 174-183 (2022) |
| بيانات النشر: | Thieme Medical Publishers, Inc., 2022. |
| سنة النشر: | 2022 |
| المجموعة: | LCC:Surgery |
| مصطلحات موضوعية: | anterior cranial fossa, cranial base, craniofacial trauma, skull base reconstruction, pericranial flap, titanium mesh cranioplasty, Surgery, RD1-811 |
| الوصف: | Management of traumatic skull base fractures and associated complications pose a unique reconstructive challenge. The goals of skull base reconstruction include structural support for the brain and orbit, separation of the central nervous system from the aerodigestive tract, volume to decrease dead space, and restoration of the three-dimensional appearance of the face and cranium with bone and soft tissues. An open bicoronal approach is the most commonly used technique for craniofacial disassembly of the bifrontal region, with evacuation of intracranial hemorrhage and dural repair performed prior to reconstruction. Depending on the defect size and underlying patient and operative factors, reconstruction may involve bony reconstruction using autografts, allografts, or prosthetics in addition to soft tissue reconstruction using vascularized local or distant tissues. The vast majority of traumatic anterior cranial fossa (ACF) injuries resulting in smaller defects of the cranial base itself can be successfully reconstructed using local pedicled pericranial or galeal flaps. Compared with historical nonvascularized ACF reconstructive options, vascularized reconstruction using pericranial and/or galeal flaps has decreased the rate of cerebrospinal fluid (CSF) leak from 25 to 6.5%. We review the existing literature on this uncommon entity and present our case series of n = 6 patients undergoing traumatic reconstruction of the ACF at an urban Level 1 trauma center from 2016 to 2018. There were no postoperative CSF leaks, mucoceles, episodes of meningitis, or deaths during the study follow-up period. In conclusion, use of pericranial, galeal, and free flaps, as indicated, can provide reliable and durable reconstruction of a wide variety of injuries. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2234-6163 2234-6171 |
| Relation: | https://doaj.org/toc/2234-6163; https://doaj.org/toc/2234-6171 |
| DOI: | 10.1055/s-0042-1744406 |
| URL الوصول: | https://doaj.org/article/ff4d5c968921492886eff802c7007979 |
| رقم الأكسشن: | edsdoj.ff4d5c968921492886eff802c7007979 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 22346163 22346171 |
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| DOI: | 10.1055/s-0042-1744406 |