Executive Editor: Daniel Buchbinder General Editor: Daniel Buchbinder

Authors: S Fusetti, B Hammer, R Kellman, C Matula, EB Strong, Co-author: A Di Ieva

Skull base & Cranial vault - Skull base, central (anterior)

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Glossary

General considerations

The central (anterior) skull base is formed by the crista galli, the cribriform plate of the ethmoid plane and the planum of the sphenoid bone.

Observation
Main indication Skill Equipment
Non- or minimally displaced fractures without CNS injury and stable neurological status. Basic surgical experience, no specialized skills Basic equipment only

Further indications

  • Undisplaced or minimally displaced fracture
  • When there is no evidence of an intracranial mass lesion (bleeding), CSF leak (CSF rhinorrhea), or increase in intracranial pressure
  • Stable neurological status (high Glasgow coma scale GSC)
Endoscopic repair of CSF leak
Main indication Skill Equipment
Central anterior skull base fractures resulting in CSF rhinorrhea. Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Advantages

  • Avoids a craniotomy and the morbidity associated with the retraction of the frontal lobe
  • Avoids injury to the olfactory apparatus
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

v1.0 2011-05-14