Objectives We aim to present our experience of managing traumatic base of skull fractures and our outcomes.
Design Retrospective case note review.
Subjects All patients in our trauma database with radiographic evidence of a skull base fracture from January 2010 to June 2017.
Methods Skull base fractures were classified according to their anatomical location. Evidence of vascular injury, CSF leak or cranial nerve injury were recorded. The mechanism of injury, length of follow up, interventions and outcomes were documented.
Results 872 cases had a skull base fracture diagnosed by head CT scan, of which 760 had sufficient radiological and clinic data to analyse. 79.4% of the cohort were male, with a mean age of 43 years. Median length of stay was 8 days and median length of follow up was 114 days. 40.1% were lost to follow up. The mortality rate was 14.9%. Injuries predominantly affected the middle cranial fossa. Vascular injury was the commonest complication (n=87), followed by CSF leak (n=38). 28 patients sustained injury to the facial nerve. Complications were managed conservatively in most cases.
Conclusions There is little reported literature on the long term outcomes of patients who sustain CSF leak, vascular injury or cranial nerve deficit following a base of skull fracture. In our experience, many of these patients are lost to follow up and indeed, the nature of this study is limited by it’s retrospective nature. Further prospective work must be done in this patient group to better understand the history of these patients.
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