Basilar skull fractures: the petrous bone

B-ENT. 2016;Suppl 26(1):193-201.

Abstract

Basilar skullfractures: the petrous bone.

Objectives: to provide suggestions for the management of three of the most dangerous or important lesions (internal carotid artery lesions, cerebrospinal fluid leaks and facial nerve paralysis) associated with the petrous part of basilar skull fractures, thereby trying to assess categories of evidence and determine strengths of recommendation.

Methodology: A PubMed-based literature review was carried out, as well as a consultation of online sources as encountered in the literature review. Also, a non-systematic search of chapters of well-known books dealing with the subject of temporal bone traumata was conducted.

Results: Specific levels of evidence and/or strength of recommendation can be retrieved from the literature, but only with respect to the prophylactic use of antibiotics, the prescription of antithrombotic medications and the indications for angiography.

Conclusion: The ample amount of available literature allows for sound management decisions, with reference made to algorithms when available in the literature. Nevertheless, for most of the management/search questions, categories of evidence and strength of recommendation are low or lacking.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Carotid Artery Injuries / diagnostic imaging
  • Carotid Artery Injuries / etiology
  • Carotid Artery Injuries / therapy*
  • Carotid Artery, Internal / diagnostic imaging
  • Cerebral Angiography
  • Cerebrospinal Fluid Leak / diagnostic imaging
  • Cerebrospinal Fluid Leak / etiology
  • Cerebrospinal Fluid Leak / therapy*
  • Facial Nerve Diseases / diagnostic imaging
  • Facial Nerve Diseases / etiology
  • Facial Nerve Diseases / therapy*
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Petrous Bone / injuries*
  • Skull Fracture, Basilar / complications
  • Skull Fracture, Basilar / diagnostic imaging
  • Skull Fracture, Basilar / therapy*

Substances

  • Anti-Bacterial Agents
  • Fibrinolytic Agents