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Anterior craniofacial resection — for paranasal sinus tumors involving anterior skull base

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Abstract

Management of anterior skull base tumors is complex due to the anatomic detail of the region and the variety of tumors that occur in this area. Currently, the “gold standard” for surgery is the anterior craniofacial approach. Craniofacial resection represents a major advance in the surgical treatment of tumors of the paranasal sinuses involving anterior skull base. It allows wide exposure of the complex anatomical structures at the base of skull permitting monobloc tumor resection. This study presents a series of 18 patients with anterior skull base tumors, treated by a team of head-neck surgeons and neurosurgeons. The series included 15 malignant tumors of the nose and paranasal sinuses and 3 extensive benign lesions. All tumors were resected by a combined bi-frontal craniotomy and rhinotomy. The skull base was closed with a pediculated pericranial flap and a split-thickness free skin graft underneath. There were no postoperative problems of wound infection, cerebrospinal fluid-leakage or meningitis. Recurrent tumor growth or systemic metastasis occurred in 3 out of 15 patients with malignant tumors, 6 months to 2 years postoperatively. Craniofacial resection was thus found to give excellent results with low morbidity in malignant lesions and can also be adapted for benign tumors of anterior skull base.

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  1. Blacklock JB, Weber RS, Lee YY, Goepfert H (1989) Transcranial resection of tumors of the paranasal sinuses and nasal cavity. J Neurosurg 71(1):10–15

    Article  CAS  PubMed  Google Scholar 

  2. Lund VJ, Howard D, Wei W, Spittle M (2003) Olfactory neuroblastoma: past, present, and future? Laryngoscope 113(3):502–507

    Article  PubMed  Google Scholar 

  3. Levine PA, Debo RF, Meredith SD, Jane JA, Constable WC, Cantrell RW () Craniofacial resection at the University of Virginia (1976–1992): survival analysis. Head Neck 16(6):574–577

    Article  Google Scholar 

  4. Lund VJ, Harrison FD (1988) Craniofacial resection for tumors of the nasal cavity and paranasal sinuses. Am J Surg 156(3 Pt 1):187–190

    Article  CAS  PubMed  Google Scholar 

  5. Bahadur S, Tandon DA, Mahapatra AK, Misra NK (1996) Craniofacial resection for lesions involving anterior base of skull. Indian J Otolaryngol Head Neck Surg 48(4):295–300

    Google Scholar 

  6. Suarez C, Llorente JL, Fernandez de Leon R, Cabanillas R, Suarez V, Lopez A (2004) Anterior craniofacial resection: oncologic outcome and complications in a series of 111 cases. Acta Otorhinolaringol Esp 55(1):27–33

    CAS  Google Scholar 

  7. Cantu G, Solero CL, Mariani L, Salvatori P, Mattavelli F, Pizzi N, Riggio E (1999) Anterior craniofacial resection for malignant ethmoid tumors — a series of 91 patients. Head Neck 21(3):185–191

    Article  CAS  PubMed  Google Scholar 

  8. Goffin J, Fossion E, Plets CH, Mommaerts M, Vrielinck L (1991) Craniofacial resection for anterior skull base tumors. Acta Neurochirurgica 110(1–2):33–37

    Article  CAS  PubMed  Google Scholar 

  9. Bridger GP (1980) Radical surgery for ethmoid cancer. Arch Otolaryngol 106(10):630–634

    CAS  PubMed  Google Scholar 

  10. Bridger MW, Beale FA, Bryce DP (1978) Carcinoma of the paranasal sinuses — a review of 158 cases. J Otolaryngol 7(5):379–388

    CAS  PubMed  Google Scholar 

  11. Cavallo LM, Messina A, Cappabianca P, et al. (2005) Endoscopic endonasal surgery of the midline skull base: anatomical study and clinical considerations. Neurosurg Focus 19(1):E2

    PubMed  Google Scholar 

  12. Cheesman AD, Lund VJ, Howard DJ (1986) Craniofacial resection for tumors of the nasal cavity and paranasal sinuses. Head Neck Surg 8(6):429–435

    Article  CAS  PubMed  Google Scholar 

  13. Clifford P (1980) Transcranial — facial approach for tumors of superior paranasal sinuses and orbit. J R Soc Med 73(6):413–419

    CAS  PubMed  Google Scholar 

  14. Eibling DE, Janecka IP, Snyderman CH (1993) Metaanalysis of outcome in anterior skull base resection for squamous cell and undifferentiated carcinoma. Skull Base Surg 3:123–129

    Article  CAS  PubMed  Google Scholar 

  15. Myers EN, Carrau RL (1993) Neoplasms of the nose and paranasal sinuses. Head Neck Surg Otolaryngol 1091–1109

  16. Patel SG, Singh B, Polluri A, et al. (2003) Craniofacial surgery for malignant skull base tumors: report of an international collaborative study. Cancer 98(6):1179–1187

    Article  PubMed  Google Scholar 

  17. Schramm VL Jr, Myers EN, Maroon JC (1979) Anterior skull base surgery for benign and malignant disease. Laryngoscope 89(7 Pt 1):1077–1091

    PubMed  Google Scholar 

  18. Shah JP, Sundaresan N, Galicich J, Strong EW (1987) Craniofacial resections for tumors involving the base of the skull. Am J Surg 154(4):352–358

    Article  CAS  PubMed  Google Scholar 

  19. Shah JP, Bilsky MH, Patel SG (2002) Malignant tumors of the skull base. Neurosurg Focus 13(4):e6

    Article  PubMed  Google Scholar 

  20. Sisson GA, Bytell DE, Becker SP, Ruge D (1976) Carcinoma of the paranasal sinuses and cranial-facial resection. J Laryngol Otol 90(1):59–68

    Article  CAS  PubMed  Google Scholar 

  21. Varshney S, Saxena RK, Bishnu PP, Kaushal A (2004) Sinonasal Haemangiopericytoma. Indian J Otolaryngol Head Neck Surg 56(2):155–158

    Google Scholar 

  22. Varshney S, Saxena RK (2004) Adenoid cystic carcinoma nose AND paranasal sinuses. Indian Med Gazet 446-449

  23. Saxena RK, Varshney S, Singh J, Kaushal A, Bishnu PP (2001) Haemorrhagic cystic sino-nasal fibrous dysplasia. Indian J Otolaryngol Head Neck Surg 53(2):154–157

    Google Scholar 

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Correspondence to Saurabh Varshney.

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Varshney, S., Bist, S.S., Gupta, N. et al. Anterior craniofacial resection — for paranasal sinus tumors involving anterior skull base. Indian J Otolaryngol Head Neck Surg 62, 103–107 (2010). https://doi.org/10.1007/s12070-010-0045-1

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