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BioMed Research International
Volume 2017 (2017), Article ID 2838167, 12 pages
https://doi.org/10.1155/2017/2838167
Research Article

Management of Penetrating Skull Base Injury: A Single Institutional Experience and Review of the Literature

Department of Neurosurgery, Shanghai Institute of Neurosurgery, Shanghai Changzheng Hospital, 415 Fengyang Road, Shanghai 200003, China

Correspondence should be addressed to Lijun Hou

Received 7 May 2017; Accepted 18 June 2017; Published 30 July 2017

Academic Editor: Hideo Inaba

Copyright © 2017 Danfeng Zhang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Penetrating skull base injury (PSBI) is uncommon among head injuries, presenting unique diagnostic and therapeutic challenges. Although many cases of PSBIs have been reported, comprehensive understanding of its initial diagnosis, management, and outcome is still unavailable. Materials and Methods. A retrospective review was performed for patients treated in neurosurgical department of Changzheng Hospital for PSBIs. Presurgical three-dimensional (3D) Slicer-assisted reconstructions were conducted for each patient. Then we reviewed previous literature about all the published cases of PSBIs worldwide and discussed their common features. Results. A total of 5 patients suffering PSBIs were identified. Penetrating points as well as the surrounding neurovascular structures were clearly visualized, assisting in the presurgical planning of optimal surgical approach and avoiding unexpected vascular injury. Four patients underwent craniotomy with foreign bodies removed successfully and 1 patient received conservative treatment. All of them presented good outcomes after proper management. Conclusion. Careful physical examination and radiological evaluation are essential before operation, and angiography is recommended for those with suspected vascular injuries. 3D modeling with 3D Slicer is practicable and reliable, facilitating the diagnosis and presurgical planning. Treatment decision should be made upon the comprehensive evaluation of patient’s clinicoradiological features and characteristics of foreign bodies.