The Rhino-Neurosurgical Method for Treating Skull Fractures Involving Paranasal Sinuses

Abstract

A combined rhino-neurosurgical method of operative treatment in cases of skull fractures involving paranasal sinuses with lacerations of the dura is described. The method consists of the close co-operation of rhinologists and neurosurgeons in diagnosis and operation. The operative procedure, which is discussed in detail, is performed in two steps, one immediately following the other: (1) rhinosurgical, by a transantral procedure, and (2) neurosurgical, by a craniotomy. The aim of this method is the repair of all dural lacerations and the removal of potential inflammatory foci in the damaged sinuses threatening intracranial infections. The method was performed in 90 patients, 42 cases with recent injuries and 48 with intracranial infections after previous head trauma. The mortality rate was less than 5%.