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Surgical complication of closed craniofacial injury: 20 years experience
EANS Academy. Guo Z. Sep 27, 2019; 275996; EP05067
Abstract
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Background: craniofacial injury involves brain, skull base and paranasal sinuses as well as facial bones, its treatment need cooperation of multi-specialist. As surgery of multi-speciality was taken at one stage, operative expose was wide, and it is easy to occur surgical complication. To prevent and treat complication is key of surgical success for these patients.
Methods: from 1997 to 2017 years, 1016 cases of cranial facial injury were treated in our department. 39 cases with severe cerebral injury died, they were excluded. 977 cases were retrospectively reviewed about their traumatic type, images, operative notes, complications and treatment methods of complications, 3 months follow- up results.
Results: Among 977 cases, male 910 , female 67 cases, age ranged from19 to 69 years old, median 38.3 years old. Of 977 cases, 419 cases had cranio-orbital injury, 138 cranio-orbital-zygmotic injury, 228 cranio-orbital-nasal injury, 192 cases cranio-orbital-maxillary injury. 397 cases underwent operation within 2 weeks, 580 cases undertook operation within 1 month as they suffer rhinorrhea or otorrhea. After operation, 36 cases developed incision infection, 7 cases underwent rhinorrhea again, 1 case presented progressive diminution of visual field. Of 36 cases, 23 cases developed infection related to frontal sinus injury, 5 cases related to titanium connector. 23 cases needed re-surgery to perform the debridment and cranilization of frontal sinus, and titanium connector were removed in five cases. 8 cases received conservative therapy with antibiocs. 7 cases with CSF leak were treated with lumbar drainage. 1 cases with diminution of visual field was re-operated to decompress the optic chiasm.
Conclusions: Proper management of paranasal sinus is key to avoid the infection after craniofacial surgery. If the patient suffered the progressive diminution of visual field after operation, he should be re-operated to decompress visual chiasm.
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