Skull base fracture treatment

✖ Caution: cases have been reported with Skull base fracture where an NG tube has been passed intracranially through the fracture and is associated with fatal outcome in 64% of cases. Possible mechanisms include a cribriform plate that is thin (congenitally or due to chronic sinusitis) or fractured (due to a frontal basal skull fracture or a comminuted fracture through the skull base).

Suggested contraindications to the blind placement of an NG tube include trauma with a possible basal skull fracture, ongoing or history of previous CSF rhinorrhea, meningitis with chronic sinusitis.

Prophylactic antibiotics for skull base fracture

Most do not require treatment by themselves. However, conditions that may be associated with BSF that may require specific management include:

1. “traumatic aneurysms”

2. posttraumatic carotid-cavernous fistula

3. CSF fistula: operative treatment may be required for persistent CSF rhinorrhea; see CSF fistula (cranial)

4. meningitis or cerebral abscess: may occur with BSF into air sinuses (frontal or mastoid) even in the absence of an identifiable Cerebrospinal fluid fistula. May even occur many years after the BSF was sustained; see Post craniospinal trauma meningitis / posttraumatic meningitis

5. cosmetic deformities

6. posttraumatic facial palsy