Surgical Treatment of Traumatic Injuries of the Cranial Base

Skull-base fractures involve one or more of the bones that constitute the cranial base; the cribriform plate. the orbital plate of the frontal bone, sphenoid bone, occipital bone, and petrous or temporal bone. Although the fractures only require reduction and reconstruction when the skull base is severely comminuted or altered, even small fractures are associated with traumatic shear forces which create tears in the meninges and thus predispose to cerebrospinal fluid leaks. This article explores the preoperative, intraoperative, and postoperative management of skull-base fractures, which most commonly involves resolution of the cerebrospinal fluid leak and the prevention of future leaks or meningoencephaloceles.