Summary
Many surgical techniques are employed for access to midline lesions of the anterior and middle fossa. A convenient one is the midfrontobasal approach. For various indications this surgical procedure was performed in 105 patients. Its benefits are outlined and a method for dealing with the two main drawbacks, postoperative loss of the sense of smell and the presumed risk of infection related to the inevitable opening of the frontal sinus, are described. In 83% of the cases the authors were able to anatomically retain the olfactory nerves, with preservation of the sense of smell in at least 65% of them. The frontal sinus was opened in 76% of the cases. The incidence of infection in the simple and quick integral reconstruction appeared 1%, equal to the rate of infection in the classical reduction of the frontal sinus by a periosteal flap.
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References
Al-Mefty O (1989) Surgical anatomy of the juxtasellar area. In: Surgery of the cranial base. Kluwer, Boston, pp 21–30
Al-Mefty O (1989) Complications of juxtasellar surgery. In: Surgery of the cranial base. Kluwer, Boston, pp 119–126
Donald PJ (1995) Anatomy and histology of the frontal sinus. In: Donald PJ, Gluckman JL, Rice DH (eds) The sinuses. Raven, New York
Fearnside MR, Grant JMF (1972) Acute necrotizing encephalitis complicating bifrontal craniotomy and pituitary curettage. J Neurosurg 36: 499–502
Malis LI (1985) Surgical resection of tumors of the skull base. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 1011–1021
Mann W,et al (1989) The state of the frontal sinus after craniotomy. Acta Neurochir (Wien) 100: 101–103
Patterson Jr RH (1985) Subfrontal approach to the pituitary gland. In: Wilkins RH, Rengachary SS (eds) Neurosurgery. McGraw-Hill, New York, pp 902–904
Pool JL (1961) Aneurysms of the anterior communicating artery, bifrontal craniotomy and the routine use of temporary clips. J Neurosurg 18: 98–112
Pool JL (1972) Bifrontal craniotomy for anterior communicating artery aneurysms. J Neurosurg 36: 212–220
Schramm Jr VL, Maroon JC (1979) Sinus complications of frontal craniotomy. Laryngoscope 89: 1436–1445
Seeger W (1980) Microsurgery of the brain. Springer, Wien New York, pp 80–81
Suzuki J,et al (1981) Preservation of the olfactory tract in bifrontal craniotomy for ACoA aneurysms, and the functional prognosis. J Neurosurg 54: 342–345
Suzuki J,et al (1986) Bifrontal interhemispheric approach to aneurysms of the anterior communicating artery. J Neurosurg 64: 183–190
Van Ek B,et al (1992) Clinical, bacteriological and cost-reducing effects of antibiotic prophylaxis in craniotomy cases. NTVG 136: 16–20
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van Dijk, J.M.C., Thomeer, R.T.W.M. Control of complications in the midfrontobasal approach. Acta neurochir 139, 355–358 (1997). https://doi.org/10.1007/BF01808833
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DOI: https://doi.org/10.1007/BF01808833