Extended Frontobasal Approach for Skull Base Lesions

Background Lesions involving the skull base can be approached by a variety of surgical corridors and extended frontobasal approach is one of them. It provides quite a wide exposure to lesions in the midline of anterior skull base, paranasal sinuses, and sphenoclival region. Objective To share our e...

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Main Authors: Mohd Faheem, Raj Kumar, Hanuman Prasad Prajapati
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2021-03-01
Series:Indian Journal of Neurosurgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1716931
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author Mohd Faheem
Raj Kumar
Hanuman Prasad Prajapati
author_facet Mohd Faheem
Raj Kumar
Hanuman Prasad Prajapati
author_sort Mohd Faheem
collection DOAJ
description Background Lesions involving the skull base can be approached by a variety of surgical corridors and extended frontobasal approach is one of them. It provides quite a wide exposure to lesions in the midline of anterior skull base, paranasal sinuses, and sphenoclival region. Objective To share our experience, and list the merits and demerits, of this approach for anterior skull base lesions. Methods A total of six cases were operated using extended frontobasal approach. Four of them were skull base tumors with extensive involvement of paranansal sinuses and extension into sellar, parasellar, and clival region. Fronto-orbital and sphenoethmoidal osteotomy provided adequate surgical access, thereby facilitating their excision. Two cases of frontonaso-orbital encephalocele with large bone defect at anterior skull base were also operated upon. Skull base repair was performed using autologous bone graft, pericranium, and fibrin glue. Results  Gross total excision was achieved in four cases of skull base tumors with good cosmesis as transfacial access was obviated. Excision, repair, and reconstruction of two patients with frontonaso-orbital encephalocele were also done with acceptable cosmesis. Conclusion The extended frontobasal approach is an excellent alternative for extensive anterior skull base tumors (up to posterior skull base), and also for the repair of large malformative lesions of the anterior skull base.
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spelling doaj-art-2bcaad90c2284976b6dbef2ed8f4ee042025-08-20T02:04:31ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Neurosurgery2277-954X2277-91672021-03-01100104905310.1055/s-0040-1716931Extended Frontobasal Approach for Skull Base LesionsMohd Faheem0Raj Kumar1Hanuman Prasad Prajapati2Department of Neurosurgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, IndiaDepartment of Neurosurgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, IndiaDepartment of Neurosurgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, IndiaBackground Lesions involving the skull base can be approached by a variety of surgical corridors and extended frontobasal approach is one of them. It provides quite a wide exposure to lesions in the midline of anterior skull base, paranasal sinuses, and sphenoclival region. Objective To share our experience, and list the merits and demerits, of this approach for anterior skull base lesions. Methods A total of six cases were operated using extended frontobasal approach. Four of them were skull base tumors with extensive involvement of paranansal sinuses and extension into sellar, parasellar, and clival region. Fronto-orbital and sphenoethmoidal osteotomy provided adequate surgical access, thereby facilitating their excision. Two cases of frontonaso-orbital encephalocele with large bone defect at anterior skull base were also operated upon. Skull base repair was performed using autologous bone graft, pericranium, and fibrin glue. Results  Gross total excision was achieved in four cases of skull base tumors with good cosmesis as transfacial access was obviated. Excision, repair, and reconstruction of two patients with frontonaso-orbital encephalocele were also done with acceptable cosmesis. Conclusion The extended frontobasal approach is an excellent alternative for extensive anterior skull base tumors (up to posterior skull base), and also for the repair of large malformative lesions of the anterior skull base.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1716931extended frontobasal approachskull baseparanasal sinuses
spellingShingle Mohd Faheem
Raj Kumar
Hanuman Prasad Prajapati
Extended Frontobasal Approach for Skull Base Lesions
Indian Journal of Neurosurgery
extended frontobasal approach
skull base
paranasal sinuses
title Extended Frontobasal Approach for Skull Base Lesions
title_full Extended Frontobasal Approach for Skull Base Lesions
title_fullStr Extended Frontobasal Approach for Skull Base Lesions
title_full_unstemmed Extended Frontobasal Approach for Skull Base Lesions
title_short Extended Frontobasal Approach for Skull Base Lesions
title_sort extended frontobasal approach for skull base lesions
topic extended frontobasal approach
skull base
paranasal sinuses
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1716931
work_keys_str_mv AT mohdfaheem extendedfrontobasalapproachforskullbaselesions
AT rajkumar extendedfrontobasalapproachforskullbaselesions
AT hanumanprasadprajapati extendedfrontobasalapproachforskullbaselesions