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Chapter 10 - Transbasal and Transfacial Approach for Paranasal and Anterior Cranial Fossa Tumors

from Section II - Open Combined Approaches

Published online by Cambridge University Press:  05 October 2021

By
Michael J. Link  and
Eric Moore
Edited by
Vijay Agarwal
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Summary

The transbasal approach has historically been a work-horse for access to lesions in the anterior fossa, orbit, nasal cavity, paranasal sinuses, pterygopalatine fossa, and pituitary fossa. When combined with a transfacial route, increased visualization and access is provided to deeper structures with minimal brain retraction and decreased risk to neural and vascular structures. Due to the complexity of this approach, oftentimes requiring multiple surgical teams participating, the decision to utilize it should be made on a case-by-case basis after a multidisciplinary discussion. This chapter discusses the indications, anatomical, and surgical details required to treat benign and malignant neoplasms involving the anterior skull base, paranasal sinuses, and potentially the orbits.

Keywords

encephaloceleCSF leakskull base surgerytransmastoid approachmiddle cranial fossa approachcombined approachmiddle ear obliteration
Type
Chapter
Information
Integrated Management of Complex Intracranial Lesions
Open, Endoscopic, and Keyhole Techniques
 , pp. 104 - 110
Publisher: Cambridge University Press
Print publication year: 2021

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References

Patel, SG, Singh, B, Polluri, A, et al. Craniofacial surgery for malignant skull base tumors. Cancer. 2003;98(6):1179–87.CrossRefGoogle ScholarPubMed
Feiz-Erfan, I, Spetzler, RF, Horn, EM, et al. Proposed classification for the transbasal approach and its modifications. Skull Base. 2008;18(1):29–47.CrossRefGoogle ScholarPubMed
Jittapiromsak, P, Wu, A, Deshmukh, P, et al. Comparative analysis of extensions of transbasal approaches: effect on access to midline and paramedian structures. Skull Base. 2009;19(6):387–99.Google Scholar
Kim, SR, Lee, JW, Han, YS, Kim, HK. Transfacial surgical approaches to secure wide exposure of the skull base, transfacial surgical approaches to secure wide exposure of the skull base. Arch Craniofac Surg. 2015;16(1):17–23.CrossRefGoogle ScholarPubMed
Spetzler, RF, Herman, JM, Beals, S, Joganic, E, Milligan, J. Preservation of olfaction in anterior craniofacial approaches. Journal of Neurosurgery. 1993;79(1):48–52.CrossRefGoogle ScholarPubMed

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