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April 1993

The Subcranial Approach for Fronto-Orbital and Anteroposterior Skull-Base Tumors

Author Affiliations

Karl Leibinger, Eng
From the Department of Cranio-Maxillofacial Facial Plastic and Reconstructive Surgery, Otolaryngology—Head and Neck Surgery, University of Bern (Switzerland) (Drs Raveh, Laedrach, Speiser, and Vuillemin); the Department of Otolaryngology—Head and Neck Surgery, Sunnybrook Medical Center, Toronto, Ontario (Dr Chen); the Department of Neurosurgery, University of Bern (Switzerland) (Drs Seiler and Ebeling); and the Research Institute, Institute Leibiger GmbH, Freiburg, Germany (Mr Leibinger).

Arch Otolaryngol Head Neck Surg. 1993;119(4):385-393. doi:10.1001/archotol.1993.01880160029006

• We describe 78 patients with fronto-orbital and sphenoethmoidal tumors surgically treated with the subcranial approach. This approach was developed by us in 1978 primarily for the treatment of skull-base trauma and craniofacial anomalies. Since 1980, we have extended the indications to include tumor resections. This extended anterior exposure of the anterior fossa skull base, including the sphenoidal and clival planes, enables an en bloc tumor removal obviating the transfrontal approach or lateral rhinotomy. In contrast with the conventional transcranial approach, the anterior subcranial approach provides an extended exposure of these locations, avoiding frontal lobe retraction. Reduction of complications, such as recurrent cerebrospinal fluid leaks, postoperative brain edema, damage to cranial nerves, and infection plus decreased hospitalization, are the major advantages of this procedure.

(Arch Otolaryngol Head Neck Surg. 1993;119:385-393)

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