[Effects of trauma to the facial bones on the anterior shelf of the base of the skull (author's transl)].

The different types of fractures of the upper jaw and facial bones and their extension to the anterior wall of the frontal sinus are discussed. Possible effects on the bony floor of the anterior shelf of the base of the skull and subjacent meninges are outlined. These injuries are then reviewed as part of the larger picture of lesions of the middle third of the craniofacial region. Several types can be distinguished:I.--Lesions in the anterior wall of the frontal sinus only, II.--Lesions affecting the base of the facial bones, III.--Lesions in the frontal vault radiating to the base, IV.--Direct lesions of the middle third, V.--Isolated lesions from back-lash or distortion, VI.--External fronto-orbital impactions. Only types 2, 3, 4, and 5 affect the middle third of the endocranial region. As far as the risk of fistula formation is concerned, facial lesions (type 2) have a good prognosis, while frontal lesions (type 3, 4, and 5) have a poor prognosis. This criterium can assist in making decisions, after superficial examination of the lesions, whether to employ major surgery or not in a deep, difficult region.