The versatile frontal sinus approach to the floor of the anterior cranial fossa

1990 ◽  
Vol 72 (3) ◽  
pp. 513-516 ◽  
Author(s):  
John A. Persing ◽  
John A. Jane ◽  
Paul A. Levine ◽  
Robert W. Cantrell
Keyword(s):  
Frontal Sinus ◽  
Cranial Base ◽  
Anterior Cranial Fossa ◽  
Operative Field ◽  
Content Type ◽  
Cosmetic Results ◽  
Anterior Cranial Base ◽  
Cranial Fossa ◽  
Burr Holes ◽  
Fine Print

✓ A technique to expose the anterior cranial base is described with entry through the anterior and posterior walls of the frontal sinus. Burr holes are avoided in the visible portion of the forehead. Expansion of the operative field may be accomplished, if necessary, by supplemental superior frontal or supraorbital rim osteotomy. The technique is rapid, safe, and provides excellent operative exposure and superior cosmetic results.

Intracranial diverticulum of the frontal sinus as a complication of frontal craniotomy

1979 ◽  
Vol 51 (6) ◽  
pp. 870-871 ◽  
Author(s):  
L. Anne Hayman ◽  
Alfonso E. Aldama-Luebbert ◽  
Robert A. Evans
Keyword(s):  
Frontal Sinus ◽  
Anterior Cranial Fossa ◽  
Content Type ◽  
Sinus Wall ◽  
Cranial Fossa ◽  
Sinus Mucosa ◽  
Fine Print

✓ A large air-filled intracranial extradural diverticulum of the frontal sinus mucosa was removed from the anterior cranial fossa of a 47-year-old man 2 years after fracture of the posterior sinus wall during craniotomy.

Osteoblastoma of the nasal cavity invading the anterior skull base in a young child

1997 ◽  
Vol 87 (4) ◽  
pp. 625-628 ◽  
Author(s):  
Keisuke Imai ◽  
Kounosuke Tsujiguchi ◽  
Chiaya Toda ◽  
Ki-Chul Sung ◽  
Sadao Tajima ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Nasal Bone ◽  
Cranial Base ◽  
Magnetic Resonance Images ◽  
Content Type ◽  
X Ray ◽  
Anterior Cranial Base ◽  
Radiological Images ◽  
Benign Osteoblastoma ◽  
Fine Print

✓ The benign osteoblastoma is rarely seen as a tumor of the facial bone in infancy or early childhood. Only five cases with nasal involvement have been reported in the literature. The authors present a case of osteoblastoma of the nasal cavity, the nasal bone, the ethmoid sinus, and the anterior cranial base. This 3-year-old girl presented with a tumor surrounding the left medial canthus. Imaging studies, including x-ray films, computerized tomography scans, magnetic resonance images, a 99mTc-scintigram, and angiograms, confirmed the location of the tumor. A biopsy specimen of tumor was obtained intranasally and the pathological diagnosis was an osteoblastic tumor suggestive of osteoblastoma. Although the tumor margin was well defined on the radiological images, it was difficult to determine the exact margin during the operation. Therefore, it is important to show how to excise the tumor completely under direct view. With the use of a “dismasking flap,” it was possible to resect the benign osteoblastoma completely from the nasal cavity, even though it extended into the orbit, the maxilla, and the anterior cranial base.

Refined and Simplified Surgical Landmarks for the MacCarty Keyhole and Orbitozygomatic Craniotomy

2010 ◽  
Vol 66 (suppl_2) ◽  
pp. ons230-ons233 ◽  
Author(s):  
R. Shane Tubbs ◽  
Marios Loukas ◽  
M.M. Shoja ◽  
Aaron A. Cohen-Gadol
Keyword(s):  
Frontal Sinus ◽  
Lateral Wall ◽  
Burr Hole ◽  
Anterior Cranial Fossa ◽  
Orbital Roof ◽  
Alternative Method ◽  
Lateral Extent ◽  
Cranial Fossa ◽  
Burr Holes ◽  
External Landmark

Abstract BACKGROUND Precise placement of the MacCarty keyhole, a burr hole simultaneously exposing the anterior cranial fossa floor and orbit, provides accurate, efficient entry for orbitozygomatic and supraorbital craniotomies. To locate the optimal keyhole site, previous studies have used superficial landmarks that, in our experience, are not always visible or consistent on older crania. OBJECTIVE Therefore, we present a technique for accurate keyhole placement using landmarks that are easily visible across age ranges. METHODS From inside the cranium, 1-mm burr holes were placed along the anterior junction of the floor and lateral wall of the anterior cranial fossa in 50 adult skulls (100 sides, with calvaria removed). Additionally, from inside the orbit, 1-mm burr holes were placed into the lateral orbital roof. Exit sites of intracranial and intraorbital burr holes were referenced to the frontozygomatic suture. The center of the site between the exiting intracranial and intraorbital holes was deemed the best location for the keyhole. RESULTS The keyhole center was 6.8 mm (mean) superior and 4.5 mm (mean) posterior to the frontozygomatic suture, which was easily identified on all specimens. Although this keyhole center was slightly more superior on right sides than left, this was not statistically significant. In a minority of specimens, the keyhole was located near the meningo-orbital foramen (22%) and the lateral extent of the frontal sinus (2%). CONCLUSIONS We defined an alternative method for locating the MacCarty keyhole, based on a reliable external landmark, approximately 7 mm superior and 5 mm posterior to the frontozygomatic suture.

Madreporic coral: a new bone graft substitute for cranial surgery

1988 ◽  
Vol 69 (4) ◽  
pp. 510-513 ◽  
Author(s):  
François X. Roux ◽  
Daniel Brasnu ◽  
Bernard Loty ◽  
Bernard George ◽  
Geneviève Guillemin
Keyword(s):  
Bone Graft ◽  
Reconstructive Surgery ◽  
Experimental Studies ◽  
Bone Graft Substitute ◽  
Biological Properties ◽  
Content Type ◽  
Skull Defects ◽  
Cranial Fossa ◽  
Burr Holes ◽  
Fine Print

✓ Since 1985, the authors have been using madreporic coral fragments (genera Porites) as a bone graft substitute. Of the 167 coral grafts implanted, 150 were coral “corks” used to obliterate burr holes (diameter 10 mm), five were large implants (length 20 to 40 mm) to repair skull defects, and 12 were coral blocks to reconstruct the floor of the anterior cranial fossa. Previous experimental studies suggested that coral grafts would be well tolerated and become partially reossified as the calcific skeleton was resorbed. The authors describe their experience and detail the main biological properties of these materials, which appear to be very promising for use in cranial reconstructive surgery.

Frontal plagiocephaly secondary to synostosis of the frontosphenoidal suture

1995 ◽  
Vol 83 (4) ◽  
pp. 733-736 ◽  
Author(s):  
Paul C. Francel ◽  
T. S. Park ◽  
Jeffrey L. Marsh ◽  
Bruce A. Kaufman
Keyword(s):  
Physical Examination ◽  
Three Dimensional ◽  
Cranial Base ◽  
Facial Skeleton ◽  
Deformational Plagiocephaly ◽  
Content Type ◽  
X Ray ◽  
Anterior Cranial Base ◽  
Coronal Synostosis ◽  
Fine Print

✓ Frontal plagiocephaly may arise from either synostotic or deformational forces. Deformational causes of frontal plagiocephaly can be distinguished from synostotic causes by differences seen on physical examination, which can then be confirmed by skull x-ray films and if necessary three-dimensional computerized tomography (CT). Unilateral coronal synostosis is the main synostotic cause of frontal plagiocephaly, although it has also been seen with fusion of the frontozygomatic suture. In several syndromes presenting with bilateral coronal synostosis, fusion of the frontosphenoidal and frontoethmoidal sutures is also present. The authors report, for perhaps the first time, a case showing synostotic frontal plagiocephaly secondary to fusion of the frontosphenoidal suture alone. Although the phenotypic appearance is superficially similar to that seen in unilateral coronal synostosis, analysis of the cranial base shows markedly different effects: angulation of the anterior cranial base with respect to the posterior cranial base away from the synostotic side and angulation of the posterior cranial base with respect to the midpalatal suture also away from the synostotic side. In unilateral coronal synostosis, both angulations are toward the synostotic side. These effects on the cranial base alter its relationship to the cranial vault and the facial skeleton. Most important, frontal plagiocephaly secondary to fusion of the frontosphenoidal suture should not be overlooked as being deformational. Because this fusion is difficult or impossible to visualize by skull x-ray films, three dimensional CT must be obtained in cases that are not clearly identified as deformational plagiocephaly by physical examination.

Temporalis myofascial repair of traumatic defects of the anterior fossa

1986 ◽  
Vol 64 (6) ◽  
pp. 977-978 ◽  
Author(s):  
Ritchie P. Gillespie ◽  
Frank W. Shagets ◽  
Raul A. de los Reyes
Keyword(s):  
Bone Defects ◽  
Anterior Cranial Fossa ◽  
Content Type ◽  
Anterior Fossa ◽  
Cranial Fossa ◽  
Dural Defects ◽  
Fine Print

✓ Bilateral temporalis myofascial flaps in continuity with frontal periosteum can be used in repairing extensive dural and bone defects of the anterior cranial fossa floor. The technique of preserving and using this flap is described and offers an alternative to the use of frontal pericranial tissue for repair of anterior dural defects.

Development of anterior cranial fossa dural arteriovenous malformation following head trauma

1997 ◽  
Vol 86 (2) ◽  
pp. 291-293 ◽  
Author(s):  
Tatsuya Ishikawa ◽  
Kiyohiro Houkin ◽  
Kouichi Tokuda ◽  
Susumu Kawaguchi ◽  
Takeshi Kashiwaba
Keyword(s):  
Head Trauma ◽  
Anterior Cranial Fossa ◽  
Content Type ◽  
Sagittal Sinus ◽  
First Case ◽  
History Of ◽  
Cranial Fossa ◽  
Ethmoidal Arteries ◽  
Dural Avm ◽  
Fine Print

✓ Dural arteriovenous malformations (AVMs) are considered to be acquired lesions that develop secondary to venous obstruction, which sometimes happens in head trauma. However, there has been a report of an anterior cranial fossa dural AVM that occurred independently of a history of head trauma, and there has been speculation that these malformations are congenital. The authors recount their experience with a patient who had an anterior cranial fossa dural AVM that was discovered incidentally. The lesion was fed by the bilateral anterior ethmoidal arteries and drained into the superior sagittal sinus via frontal cortical veins. The patient had a history of severe head trauma that had occurred 30 years earlier. This is the first case report in which a previous head trauma is strongly believed to be the cause of an anterior cranial fossa dural AVM. The authors postulate that anterior cranial fossa dural AVMs can develop secondary to a head trauma.

Frontal sinus approach to the orbit

1985 ◽  
Vol 63 (5) ◽  
pp. 811-813 ◽  
Author(s):  
Austin R. T. Colohan ◽  
John A. Jane ◽  
Steven A. Newman ◽  
William W. Maggio
Keyword(s):  
Frontal Sinus ◽  
Anterior Wall ◽  
Bone Flap ◽  
Cosmetic Result ◽  
Content Type ◽  
Supraorbital Approach ◽  
Single Bone ◽  
Burr Holes ◽  
Fine Print

✓ The authors have previously advocated a supraorbital approach to tumors of the orbit. In this paper, they describe a technique in which they take advantage of a large frontal sinus as a means of entering the orbit without the necessity of intracranial exposure, as required by the more conventional supraorbital approach. This is achieved without frontal burr holes, allowing for a superior cosmetic result. The anterior wall of the frontal sinus is removed, and with it the roof of the orbit as a single bone flap. A case in which this technique was used is described.

Craniotomy for anterior cranial fossa meningiomas: historical overview

2014 ◽  
Vol 36 (4) ◽  
pp. E14 ◽  
Author(s):  
Saul F. Morales-Valero ◽  
Jamie J. Van Gompel ◽  
Ioannis Loumiotis ◽  
Giuseppe Lanzino
Keyword(s):  
Cranial Base ◽  
Anterior Cranial Fossa ◽  
Past Century ◽  
Historical Overview ◽  
Surgical Strategies ◽  
The Past ◽  
Harvey Cushing ◽  
Anterior Cranial Base ◽  
Technical Advances ◽  
Cranial Fossa

The surgical treatment of meningiomas located at the base of the anterior cranial fossa is often challenging, and the evolution of the surgical strategy to resect these tumors parallels the development of craniotomy, and neurosurgery in general, over the past century. Early successful operations to treat these tumors were pioneered by prominent figures such as Sir William Macewen and Francesco Durante. Following these early reports, Harvey Cushing made significant contributions, allowing a better understanding and treatment of meningiomas in general, but particularly those involving the anterior cranial base. Initially, large-sized unilateral or bilateral craniotomies were necessary to approach these deep-seated lesions. Technical advances such as the introduction of electrosurgery, the operating microscope, and refined microsurgical instruments allowed neurosurgeons to perform less invasive surgical procedures with better results. Today, a wide variety of surgical strategies, including endoscopic surgery and radiosurgery, are used to treat these tumors. In this review, the authors trace the evolution of craniotomy for anterior cranial fossa meningiomas.

scholarly journals Anterior Cranial Fossa Calcifying Pseudoneoplasm of the Neuroaxis—Diagnosis Using a Transblepharoplasty Approach

2018 ◽  
Vol 79 (03) ◽  
pp. e75-e78 ◽  
Author(s):  
Timothy Blood ◽  
Fausto Rodriguez ◽  
Norris Nolan ◽  
Murugappan Ramanathan ◽  
Shaun Desai
Keyword(s):  
Frontal Sinus ◽  
Spinal Column ◽  
Pathological Diagnosis ◽  
Anterior Cranial Fossa ◽  
Benign Tumors ◽  
Orbital Roof ◽  
Anterior Cranial Base ◽  
Cranial Fossa ◽  
The Right ◽  
Orbital Rim

AbstractCalcifying pseudoneoplasms of the neuroaxis (CAPNON) are rare, benign tumors of unknown histogenesis. CAPNON generally are found intracranially or within the spinal column in symptomatic patients. We present the case of an asymptomatic patient with an incidentally discovered right anterior cranial fossa mass with extension through the posterior and anterior table of the right frontal sinus and right superior orbital roof. Open biopsy was performed via a transblepharoplasty incision with pathological diagnosis of CAPNON. The biopsy approach was well hidden and resulted in minimal to no postoperative scarring and little postoperative pain. We present the first documented case of CAPNON involving the frontal sinus via the anterior cranial base. Given our experience, in a patient with a mass involving the frontal sinus and superior orbital rim, the transblepharoplasty approach provides excellent exposure and access for pathological diagnosis. Further, we recommend that CAPNON remain on the differential for aggressive appearing calcified masses of the anterior cranial fossa.

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