The subcranial approach for anterior skull base tumors

The purpose of this study is to present the technique of the extended subcranial approach to the anterior skull base, and to review the results in 56 patients. A retrospective review was conducted on the records of 56 patients who underwent this procedure for the treatment of various neoplasms originating in the nasal cavity, nasopharynx, paranasal sinuses, orbit or méninges, in an academic tertiary referral medical center. Preoperative patient evaluation, the surgical technique and complications are also reviewed. Nineteen patients had malignant tumors and 37 patients had benign tumors. There was l perioperative death (fulminant meningitis on postoperative day 28). Significant complications consisted of meningitis occurring in 2 patients and 5 cases of osteoradionecrosis with bone cutaneous fistula. The most common late complication was anosmia (27 patients). Based on this review, we feel that the extended subcranial approach to the anterior skull base is a safe, versatile, and effective procedure for the surgical treatment of tumors involving the anterior skull base.