Bony Lesions Involving the Anterior Skull Base and Paranasal Sinuses; A Series of Our Cases with Emphasis on the Intracranial and Orbital Complications

• Main Authors: Margalit, Nevo S, Ezer, Haim, Cavel, Oren, Fliss, Dan
• Format: Conference Proceeding
• Language: English
• ISSN: 1531-5010; 1532-0065
• DOI: 10.1055/s-2007-981715

Purpose: Bony lesions of the anterior skull base are variable in their biological nature and their location. We present a series of 41 patients with anterior skull base bony tumors, and we focus on the cases with intracranial or orbital complications. Methods: Our cases involved the frontal sinus, orbit, and cribriform areas. We performed a retrospective analysis using patient's files from the hospital and the outpatient clinic, operative notes, and pre- and postoperative imaging studies. The surgical technique included an anterior frontal sinus wall door (type A) or a type B subcranial approach, and reconstruction with fascia lata, titanium mesh coated with pericranium and plates, calvarial bone grafts, and fascia sling. Results: The ages of the patients were 14 to 41 (mean, 25 yrs). Fifteen of the 41 patients presented with serious intracranial or orbital complications (headaches, CSF leak, pneumocephalus, seizures or proptosis, partial ptosis, and rapid visual deterioration). Twenty were males and 21 females. We used the subcranial approach in 15 cases, and in 26 cases, only the anterior wall of the frontal sinus was removed. We achieved complete tumor removal in all cases and all are alive. Surgical complications were mostly of short duration. Conclusions: Bony lesions of the anterior skull base can have serious complications including orbital and intracranial symptomatology. Our experience shows that these lesions are resectable with generally few complications. The subcranial approach provides a wide anatomical exposure and allows the complete resection of these tumors.