Early outcome and complications of the extended subcranial approach to the anterior skull base

Dan M. Fliss, Gideon Zucker, Avi Cohen, Aharon Amir, Amiram Sagi, Lior Rosenberg, Alberto Leiberman, Albert Gatot, Eli Reichenthal

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: To present the technique of the extended subcranial approach to the anterior skull base and to review the results in 55 patients who underwent the procedure. Study Design: Retrospective review of the records of 55 patients who underwent the extended subcranial approach to the anterior skull base between 1994 and 1998 for the treatment of various neoplasms originating in the nasal cavity, nasopharynx, paranasal sinuses, orbit, or meninges, as well as for the repair of complex craniofacial trauma and/or cerebrospinal fluid (CSF) leak. Preoperative patient evaluation and the surgical technique are also reviewed. Methods: Patient records were retrospectively reviewed and tabulated for age, sex, and indications for procedure, with special focus on early outcome and complications. Results: Twenty-six patients underwent oncologic resections, 22 patients had reduction of complex fronto-naso-orbital and skull base fractures, and seven patients had repair of CSF leak. Significant complications in the oncologic group consisted of one hematoma requiring needle aspiration and two cases of temporary nontension pneumocephalus. In the fracture group, one patient died because of extensive intracerebral damage and multiorgan failure, and one patient had nontension pneumocephalus coupled with CSF leakage and one patient had temporary nontension pneumocephalus. The most common late complication in all three groups was anosmia. Conclusions: Based on their review, the authors conclude that the extended subcranial approach to the anterior skull base is a safe, versatile, and effective procedure for the surgical treatment of various pathological conditions involving the anterior skull base.

Original languageEnglish
Pages (from-to)153-160
Number of pages8
JournalLaryngoscope
Volume109
Issue number1
DOIs
StatePublished - Jan 1999
Externally publishedYes

Keywords

  • Anterior skull base
  • Cerebrospinal fluid fistula
  • Craniofacial fractures
  • Oncology
  • Surgical approaches

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