Figure 9.

The transbasal approach is well suited for managing anterior skull base trauma. (A) Coronal and (B) axial bone window computed tomography (CT) scans of the head show multiple craniofacial and skull base fractures associated with an open scalp laceration after direct blunt injury. A transbasal approach was used to repair and close the cerebrospinal fluid leak. Due to the increased risk of infection, no orbital bar osteotomies were included. (C) Six months after surgery, the patient underwent surgical débridement of purulent infection with loss of the frontal bone flap, as seen during the procedure and on a (D) postoperative bone window CT of the head. The initial use of the transbasal approach prevented the functionally and cosmetically important orbital bar from being lost to infection.