Surgical treatment of cranioorbital injuries combined with brain trauma

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Cranioorbital injuries (COI) are combined with brain trauma in 45-53% of patients and in 21-24% of cases require surgical treatment. Aim of this study was to evaluate the results of surgical treatment of patients with COI in acute period of traumatic brain injury (TBI). Among 4078 patients with TBI admitted to neurosurgical department of Sklifosovsky Institute of Emergency Medicine, 428 (10,5%) had COI. In acute period of TBI reconstructive procedures were performed in 158 (36,9%) cases. In 78 (49,4%) patients reconstructive surgical procedures were done within 48 hours after injury, in 35 (22,2%) of them simultaneously with neurosurgical operation. In 53 (33,5%) patients underwent surgical treatment in 1 week after trauma or later. Majority of procedures were reconstructive operations with reposition and rigid fixation of fractured bones using different implants. Overall mortality in patients with COI was 5,3%, postoperative mortality - 4,6%. Postoperatively position of the eyeball was restored totally or partially in 127 (97,7%), oculomotor disorders regressed in 132 (98,5%) patients. Obtained results of surgical treatment of COI in acute period of TBI demonstrate high effectiveness and safety of active surgical tactics. Application of modern diagnostic methods and interdisciplinary approach in management of COI in early period after trauma provide good functional and cosmetic results.

Keywords:

traumatic brain injury

cranioorbital injury

reconstructive and aesthetic surgery

Authors:

Levchenko O.V.

Research Emergency Institute named after N.V. Sklifosovsky, Moscow, Russia

Shalumov A.Z.

Moskovskiĭ gosudarstvennyĭ mediko-stomatologicheskiĭ universitet;
NII skoroĭ pomoshchi im. N.V. Sklifosovskogo, Moskva

Kutrovskaia N.Iu.

Moskovskiĭ gosudarstvennyĭ mediko-stomatologicheskiĭ universitet;
NII skoroĭ pomoshchi im. N.V. Sklifosovskogo, Moskva

Krylov V.V.

FGBU MRNTs Minzdrava Rossii, Obninsk

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