Article
Controversies in the management of skull base fractures
Versorgung von Schädelbasisfrakturen – Gibt es einen Standard?
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Authors
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U.M. Mauer
- Abt. Neurochirurgie, Bundeswehrkrankenhaus Ulm
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K. Panommas
- Abt. Neurochirurgie, Bundeswehrkrankenhaus Ulm
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U. Kunz
- Abt. Neurochirurgie, Bundeswehrkrankenhaus Ulm
| Published: | April 11, 2007 |
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Outline
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Objective: Skull base fractures with or without cerebrospinal fluid (CSF) leakage are crucial conditions. We have an argument in our clinic regarding the best method of management of these skull base fractures. And we searched for the standard method to deal with these patients in the other hospitals in the south of Germany.
Methods: We sent a questionnaire to 30 neurosurgery departments in south Germany. We received 24 answers.
Results: 14 neurosurgery departments prefer to use prophylactic antibiotics and only 10 departments prefer not to use prophylactic antibiotics as their standard procedure, although there is a high evidence in the actual literature against the use of prophylactic antibiotics in these patients. In addition the indications for surgical or conservative treatment differ. 20 departments routinely prefer to use the intradural neurosurgical approach. But according to the actual literature the better way is the endonasal approach. From 2000 to 2005 we found only 22% of all articles for the treatment of skull base fractures In MEDLINE posted by neurosurgeons, but 42% of the articles posted by ENT-surgeons. In the eighties this relation was just the other way.
Conclusions: The practice in the management of skull base fractures in the neurosurgical departments of south Germany does not correspond to the actual literature.
