Endoscopic Endonasal and Transglabellar Combined Approach for Removal of Frontoethmoidal Tumors. About a Series of Six Patients

• Main Authors: Litre, Claude-Fabien, Duntze, J., Eap, C., Rousseaux, P.
• Format: Conference Proceeding
• Language: English
• ISSN: 2193-6331; 2193-634X
• DOI: 10.1055/s-0034-1383982

Frontoethmoidal tumor represents a surgical challenge because of their anatomical location, the difficulty of a total removal, and the cosmetically disfiguring transfacial approaches needed. Recently, expanded endonasal endoscopic approaches have been developed, either alone or in combination with a craniotomy. We have developed a new pure endoscopic approach by an endonasal approach with an endoscopic transsinusal approach in the same procedure. We have performed a transglabellar approach first with the most important resection of the tumor. The opening with the ethmoid is closed by using the posterior wall of the frontal sinus wich is resized and put in the defect. After a modification of the position of the head, we have performed an endonasal endoscopic approach for the resection of the residue of the tumor in the same procedure. Of the patients, four were women. There were two esthesioneuroblastomas (grade 2), two giants frontoethmoidal meningiomas, and two mucoceles. Common presenting symptom was frontal syndrome (four patients), anosmia (four patients), and visual change (three patients). Gross total removal was achieved for all patients, with no deaths. One patient had postoperative cerebrospinal fluid leak. At the end of follow-up (26 months), we did not find evidence of clinical or radiological recurrence. The cosmetic result is excellent for all patients without any problem of cicatrization.