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

Figure 2

Preoperative image of foreign body (burst outer rim of a grinding wheel) in the face and middle skull base. Anterior-posterior skull radiography (a) and lateral skull radiography (b) demonstrated the short piece (simple arrow, ←) in the face and long piece (hollow arrow, ) penetrating into the middle skull base. Sagittal reconstruction of CT (c) showed the long piece penetrating into the middle cranial fossa through infratemporal fossa. A small piece of bone fragment (hollow arrowhead, ) was noticed above the long piece. The bone fragment arose from the hit of the long piece on the middle skull base. DSA (d & e) proved the integrity of MCA. Axial CT revealed close relationship between the bone fragment (hollow arrow head, ➤) and branch of MCA (f). 3D reconstruction (g, h, i) with 3D Slicer software displayed spatial correlation of two pieces of foreign body with the face and skull base. 3D, three-dimensional; CT, computed tomography; DSA, digital subtraction angiography; MCA, middle cerebral artery.

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