1/96. temporal bone fracture following blunt trauma caused by a flying fish.Blunt trauma to the temporal region can cause fracture of the skull base, loss of hearing, vestibular symptoms and otorrhoea. The most common causes of blunt trauma to the ear and surrounding area are motor vehicle accidents, violent encounters, and sports-related accidents. We present an obscure case of a man who was struck in the ear by a flying fish while wading in the sea with resulting temporal bone fracture, sudden deafness, vertigo, cerebrospinal fluid otorrhoea, and pneumocephalus.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
2/96. Growing skull fracture of ethmoid: a report of two cases.We describe a rare sequel of ethmoid fracture--a growing skull fracture associated with cerebrospinal fluid rhinorrhoea following trauma sustained in adult life. The natural history of its development, diagnosis, and the results of surgery are discussed. The literature is reviewed with regard to aetiology, incidence, imaging characteristics and management of this rare post-traumatic complication.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
3/96. Dislocation of the incus into the external auditory canal after mountain-biking accident.We report a rare case of incus dislocation to the external auditory canal after a mountain-biking accident. otoscopy showed ossicular protrusion in the upper part of the left external auditory canal. CT indicated the disappearance of the incus, and an incus-like bone was found in the left external auditory canal. There was another bony and board-like structure in the attic. During the surgery, a square-shaped bony plate (1 x 1 cm) was found in the attic. It was determined that the bony plate had fallen from the tegmen of the attic. The fracture line in the posterosuperior auditory canal extending to the fossa incudis was identified. According to these findings, it was considered that the incus was pushed into the external auditory canal by the impact of skull injury through the fractured posterosuperior auditory canal, which opened widely enough for incus dislocation.- - - - - - - - - - ranking = 243.50677090008keywords = canal (Clic here for more details about this article) |
4/96. titanium mesh repair of the severely comminuted frontal sinus fracture.BACKGROUND: Severely comminuted frontal sinus fractures are difficult to contour and immobilize. Frequently, plates or wires are inadequate in fixating all fragments together, resulting in less than optimal outcomes. Advancements in the development of biomaterials have now made titanium mesh a new option for the repair of severely comminuted fractures. methods: Fourteen patients with severely comminuted frontal sinus fractures were treated with titanium mesh from 1994 to 1999. The fractures were reduced and immobilized using a simple algorithm: (1) Isolated anterior table fractures were repaired with reduced bony fragments attached to titanium mesh. (2) Anterior table fractures with nasofrontal duct involvement were repaired by sinus obliteration and anterior wall reconstruction with reduced bony fragments attached to titanium mesh. (3) Anterior and posterior table fractures with cerebrospinal fluid leak or displacement were treated with the cranialization of the sinus and anterior wall reconstruction with reduced bony fragments attached to titanium mesh. RESULTS: Of the 14 patients treated, 12 were available for postoperative evaluation. Parameters such as nasal function, cranial nerve V and VII function, cosmesis, and complications (hardware extrusions, sinusitis, meningitis, osteomyelitis, mucopyocele, brain abscess, pneumocephalus, and cerebrospinal fluid leak) were evaluated. All patients had good function of the superior division of cranial nerves V and VII. Two patients (16%) had minor wound infections, which resolved under treatment with antibiotics. All had excellent cosmetic results as measured by postreduction radiographs and personal and family perceptions of forehead contour. CONCLUSION: titanium mesh reconstruction of severely comminuted frontal sinus fractures has few complications while providing excellent forehead contour and cosmesis.- - - - - - - - - - ranking = 2keywords = spinal (Clic here for more details about this article) |
5/96. Posttraumatic anosmia in craniofacial trauma.Although the clinical implications of anosmia can be significant, posttraumatic anosmia is generally given relatively little attention in the clinical setting. patients who sustain craniofacial trauma are most at risk. The incidence of posttraumatic anosmia varies according to the severity of injury and has an overall estimated incidence of 7%. Factors that increase the risk of developing anosmia include anterior skull base fractures, bilateral subfrontal lobe injury, dural lacerations, and cerebrospinal fluid leakage. recovery of function has been estimated to be approximately 10%. time of recovery, if it occurs, varies between 8 weeks and 2 years. Presented herein are the clinical, radiographic, pathophysiologic, and anatomic substrata of posttraumatic anosmia.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
6/96. Skull-base trauma: neurosurgical perspective.Trauma to the cranial base can complicate craniofacial injuries and lead to significant neurological morbidity, related to brain and/or cranial nerve injury. The optimal management involves a multidisciplinary effort. This article provides the neurosurgeon's perspective in management of such trauma using a 5-year retrospective analysis of patients sustaining skull-base trauma. The salient features of anterior and middle skull-base (temporal bone) trauma are summarized, and the importance of frontal basilar trauma as well as brain injury is evident. With these injuries, all cranial nerves (except 9 to 12) are at risk; the olfactory nerve and the facial nerve are the first and second, respectively, to sustain injuries. This retrospective analysis provides a better understanding of cranial base trauma and its management. It emphasizes the multifaceted nature of such trauma and the need to recognize anterior skull-base complications, including cerebrospinal fluid leak and brain injury.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
7/96. Trauma to the temporal bone: diagnosis and management of complications.The temporal bone contains important sensory and neural structures that may be damaged in patients who experience craniofacial trauma. The most serious complications of temporal bone trauma include facial nerve paralysis, cerebrospinal fluid leak, and hearing loss. Injury to the temporal bone often presents with subtle signs and symptoms, such as otorrhea, facial palsy, and hemotympanum. A high index of suspicion and a thorough knowledge of how to diagnose injury to the temporal bone are paramount in treating patients who present to the emergency room with craniofacial trauma. This article provides an overview of temporal bone trauma, outlines a methodical approach to the patient with temporal bone trauma, details four cases, and describes the treatment of complications.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
8/96. The subcranial approach to trauma of the anterior cranial base: preliminary report.The subcranial approach to the cranio-orbito-frontal junction allows direct access to the central anterior cranial base for repair of fractures, dural tears, and cerebrospinal fluid fistulae. It provides good visualization without brain retraction and is suitable in primary or delayed traumatic cases. For extended visualization, a portion of the frontal sinus may be removed and repositioned at the end of the procedure. Because the brain is not retracted, morbidity is low. Potential and active cerebrospinal fluid fistulae can be successfully managed with the use of free fascial grafts and often do not require a pericranial flap. Contraindications include parenchymal brain injury or bleeding that may require a more standard frontal craniotomy for management. The purpose of this report is to highlight the use of the subcranial approach to repair cerebrospinal fluid fistulae in immediate and delayed traumatic cases.- - - - - - - - - - ranking = 3keywords = spinal (Clic here for more details about this article) |
9/96. Management of traumatic optic neuropathy.Visual loss caused by trauma to the optic nerve is a well-recognized sequela to cranio-maxillofacial trauma. The authors reviewed their experience with 90 patients with pure traumatic optic neuropathy and optic nerve trauma with concomitant maxillofacial injuries. All patients were treated with intravenous steroids. Those not improving underwent extracranial optic canal decompression. patients with initial visual acuity of 20/100 or better all responded favorably with improvement in visual acuity or visual field to a course of intravenous megadose corticosteroids. patients with initial vision of 20/200 or worse who failed to respond to corticosteroids may have improved visual function after undergoing extracranial optic canal decompression. Preoperative and postoperative computed tomography scans on 6 patients enhanced with intrathecal iopamidol indicate the site of optic nerve compression to be at the optic canal. This article discusses the diagnosis and the medical and surgical treatment of pure and complex optic nerve injuries.- - - - - - - - - - ranking = 73.052031270024keywords = canal (Clic here for more details about this article) |
10/96. Radionuclide cisternographic evaluation and follow-up of posttraumatic subconjunctival CSF loculation. Case report.The case of a patient with massive, posttraumatic, subconjunctival cerebrospinal fluid collections is described in which diagnosis and postoperative management was simplified by serial radionuclide cisternography.- - - - - - - - - - ranking = 1keywords = spinal (Clic here for more details about this article) |
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