The Comprehensive AOCMF Classification: Skull Base and Cranial Vault Fractures – Level 2 and 3 Tutorial

Craniomaxillofacial Trauma and Reconstruction

Robert M. Kellman³  Joachim Prein²  Kevin A. Shumrick⁵  Helmut Ringl⁶  Antonio Di Ieva⁴  Christian Matula¹  Laurent Audigé⁷ 

[1] Department of Neurosurgery, Medical University of Vienna, Vienna, Austria;Clinic for Oral and Craniomaxillofacial Surgery, University Hospital Basel, Basel, Switzerland;Department of Otolarynology-Head and Neck Surgery, SUNY Upstate Medical University, Syracuse, New York;Division of Neurosurgery, St. Michael's Hospital, University of Toronto, Toronto, Canada;Group Health Associates, Cincinnati, Ohio;Department of Radiology, Medical University of Vienna, Vienna, Austria;Research and Development Department, Schulthess Clinic, Zürich, Switzerland

关键词: fracture classification;    classification system;    skull base;    cranial vault;   

DOI  :  10.1055/s-0034-1389563

学科分类：口腔科学

来源: Thieme Medical Publishers, Inc.

【 摘 要 】

The AOCMF Classification Group developed a hierarchical three-level craniomaxillofacial classification system with increasing level of complexity and details. The highest level 1 system distinguish four major anatomical units, including the mandible (code 91), midface (code 92), skull base (code 93), and cranial vault (code 94). This tutorial presents the level 2 and more detailed level 3 systems for the skull base and cranial vault units. The level 2 system describes fracture location outlining the topographic boundaries of the anatomic regions, considering in particular the endocranial and exocranial skull base surfaces. The endocranial skull base is divided into nine regions; a central skull base adjoining a left and right side are divided into the anterior, middle, and posterior skull base. The exocranial skull base surface and cranial vault are divided in regions defined by the names of the bones involved: frontal, parietal, temporal, sphenoid, and occipital bones. The level 3 system allows assessing fracture morphology described by the presence of fracture fragmentation, displacement, and bone loss. A documentation of associated intracranial diagnostic features is proposed. This tutorial is organized in a sequence of sections dealing with the description of the classification system with illustrations of the topographical skull base and cranial vault regions along with rules for fracture location and coding, a series of case examples with clinical imaging and a general discussion on the design of this classification.

【 授权许可】

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