Stato-acoustic complaints and neurootological findings
Abstract
From a major group of neurootological patients in our data-bank NODEC IV we have selected a group of patients who had suffered rhino-fronto-basal skull fractures. Some anatomical features lead to the concentration of cranial fractures to the base of the cranial vault. In case a strike hits the head frontally, forces coming from the face are transmitted along the sphenoidal and petrous rigours to the base of the skull. The bones in the orbital plates and middle cranial fossa are thin with relatively small amount of diploe. Another fact fostering the fractures of the frontal base is an abundance of foramina and grooves in the skull base.
The direct consequences of the skull base fractures result from displacement of bones and ruptures of vessels. Besides we also may see that the underlying brain is compressed and contused. In comminuted fractures there is a danger of laceration of both meninges and brain with lodgement of bone fragments as foreign bodies within the brain.
In compound fractures the scalp is also lacerated and hair and skin as well as bone fragments are carried into the brain. A septic transformation may follow.
Due to the physical forces involving the total content of the skull, i.e. the brain, we find special pressure marks and suction marks of the coup and contre-coup sides along the brain..
For our study we regard the rhino-fronto-basal fractures as a proven trauma of the brain also.
We, however, in this paper are concentrating upon frontal trauma to the base of the skull with fractures. Thereafter we are comparing in a minor group of 95 patients, which are the signs we can subjectively and objectively measure in this sample with our neurootological network analysis.