scholarly journals Anterior Craniofacial (Transcranial) Resection for Tumors of Nose and Paranasal Sinuses: Surgical Technique

2011 ◽  
Vol 3 (3) ◽  
pp. 197-201
Author(s):  
Saurabh Varshney ◽  
SS Bist ◽  
Sarita Mishra ◽  
Charitesh Gupta ◽  
Sanjiv Bhagat ◽  
...  
Keyword(s):  
Paranasal Sinus ◽  
Paranasal Sinuses ◽  
Malignant Tumors ◽  
Cribriform Plate ◽  
Anterior Cranial Fossa ◽  
Craniofacial Resection ◽  
Csf Leakage ◽  
Cranial Fossa ◽  
The Mean ◽  
Nose And Paranasal Sinuses

ABSTRACT Background Management of nose and paranasal sinus tumors involving the cribriform plate with or without invasion of anterior cranial fossa is complex due to the anatomic detail of the region and the variety of tumors that occur in this area. Anterior craniofacial resection is recognized as the best treatment for nose and paranasal sinus, tumors involving the cribriform plate with or without invasion of anterior cranial fossa. Craniofacial resection allows wide exposure of the complex anatomical structures at the base of skull permitting monobloc tumor resection. Methods Twenty-one patients underwent anterior craniofacial resection for nose and paranasal sinus tumors involving the cribriform plate with or without invasion of anterior cranial fossa at Himalayan Institute of Medical Sciences, Dehradun between 2000 and 2011 by a team of head-neck surgeons and neurosurgeons. Results The series included 16 malignant tumors of the nose and paranasal sinuses and five extensive benign lesions. The mean age was 47.4 years (range, 12 to 68 years). There were 16 men and five women (M:F- 3.2:1.0). Four patients had a recurrence after previous treatments (surgery and/or radiotherapy). The histological subdivision was as follows: Seven cases of squamous cell carcinoma, four cases of adenocarcinoma, three cases of esthesioneuroblastoma, and two cases of undifferentiated tumors. All tumors were resected by a combined bifrontal craniotomy and rhinotomy. The skull base was closed with a pediculated pericranial flap and a split-thickness free skin graft underneath. There were no postoperative problems of CSF-leakage or meningitis, two patients had wound infection. Recurrent tumor growth or systemic metastasis occurred in three (18.75%) out of 16 patients with malignant tumors, 6 months to 2 years postoperatively. The mean follow-up was 16 months. Conclusion An anterior craniofacial resection should be performed in cases of nose and paranasal sinus tumors involving the cribriform plate with or without invasion of anterior cranial fossa.

Craniofacial resection for extensive paranasal sinus aspergilloma

1988 ◽  
Vol 102 (12) ◽  
pp. 1172-1175 ◽  
Author(s):  
R. E. Quiney ◽  
M. J. C. Rogers ◽  
R. N. Davidson ◽  
A. D. Cheesman
Keyword(s):  
Paranasal Sinus ◽  
High Mortality ◽  
Surgical Approach ◽  
Paranasal Sinuses ◽  
Craniofacial Surgery ◽  
Anterior Cranial Fossa ◽  
Malignant Tumours ◽  
Craniofacial Resection ◽  
Cranial Fossa ◽  
Ethmoid Region

AbstractCraniofacial resection techniques were developed to allow complete monobloc removal of malignant tumours of the ethmoid region. Such a surgical approach may also occasionally be useful in certain non-malignant conditions. Extensive ‘destructive’ aspergillosis of the paranasal sinuses has a high mortality once the anterior cranial fossa dura is reached. Craniofacial surgery provides excellent access to excise such large infective ‘tumours’.

Ossifying Fibroma Involving the Paranasal Sinuses, Orbit, and Anterior Cranial Fossa

Neurosurgery ◽  
1995 ◽  
Vol 36 (6) ◽  
pp. 1192-1195 ◽  
Author(s):  
Kazuhiko Nakagawa ◽  
Yoshio Takasato ◽  
Yoshifumi Ito ◽  
Kazuaki Yamada
Keyword(s):  
Paranasal Sinuses ◽  
Anterior Cranial Fossa ◽  
Ossifying Fibroma ◽  
Cranial Fossa

Endoscopic Endonasal Transethmoidal Transcribriform Transfovea Ethmoidalis Approach to the Anterior Cranial Fossa and Skull Base

Neurosurgery ◽  
2010 ◽  
Vol 66 (5) ◽  
pp. 883-892 ◽  
Author(s):  
Jeffrey P. Greenfield ◽  
Vijay K. Anand ◽  
Ashutosh Kacker ◽  
Michael J. Seibert ◽  
Ameet Singh ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Skull Base ◽  
Sphenoid Sinus ◽  
Malignant Tumors ◽  
Anterior Skull Base ◽  
Anterior Cranial Fossa ◽  
Csf Leak ◽  
Endoscopic Endonasal ◽  
Lumbar Drainage ◽  
Cranial Fossa

Abstract OBJECTIVE The anterior skull base, in front of the sphenoid sinus, can be approached using a variety of techniques including extended subfrontal, transfacial, and craniofacial approaches. These methods include risks of brain retraction, contusion, cerebrospinal fluid leak, meningitis, and cosmetic deformity. An alternate and more direct approach is the endonasal, transethmoidal, transcribriform, transfovea ethmoidalis approach. METHODS An endoscopic, endonasal approach was used to treat a variety of conditions of the anterior skull base arising in front of the sphenoid sinus and between the orbits in a series of 44 patients. A prospective database was used to detail the corridor of approach, closure technique, use of intraoperative lumbar drainage, operative time, and postoperative complications. Extent of resection was determined by a radiologist using volumetric analysis. RESULTS Pathology included meningo/encephaloceles (19), benign tumors (14), malignant tumors (9), and infectious lesions (2). Lumbar drains were placed intraoperatively in 20 patients. The CSF leak rate was 6.8% for the whole series and 9% for intradural cases. Leaks were effectively managed with lumbar drainage. Early reoperation for cerebrospinal fluid (CSF) leak occurred in 1 patient (2.2%). There were no intracranial infections. Greater than 98% resection was achieved in 12 of 14 benign and 5 of 9 malignant tumors. CONCLUSION The endoscopic, endonasal, transethmoidal, transcribriform, transfovea ethmoidalis approach is versatile and suitable for managing a variety of pathological entities. This minimal access surgery is a feasible alternative to transcranial, transfacial, or combined craniofacial approaches to the anterior skull base and anterior cranial fossa in front of the sphenoid sinus. The risk of CSF leak and infection are reasonably low and decrease with experience. Longer follow-up and larger series of patients will be required to validate the long-term efficacy of this minimally invasive approach.

scholarly journals Clinical Study of Malignant Tumors of the Nose and Paranasal Sinuses

1981 ◽  
Vol 74 (5special) ◽  
pp. 959-971
Author(s):  
Fumi Hamaguchi ◽  
Yasuro Miyoshi ◽  
Yasuo Sakakura ◽  
Kotaro Ukai ◽  
Mikikazu Yamagiwa ◽  
...  
Keyword(s):  
Clinical Study ◽  
Paranasal Sinuses ◽  
Malignant Tumors ◽  
Nose And Paranasal Sinuses

scholarly journals OLFACTORY GROOVE MENINGIOMAS – CLINICAL PRESENTATION, TREATMENT AND OUTCOMES

2015 ◽  
Vol 2 (1) ◽  
pp. 34-48
Author(s):  
Tabita Larisa Cazac ◽  
Ioana Andreea Dărămuș ◽  
B. C. Dumitrescu ◽  
C. Toader
Keyword(s):  
Visual Acuity ◽  
Cribriform Plate ◽  
Anterior Cranial Fossa ◽  
External Carotid ◽  
Olfactory Groove ◽  
Mental Disturbances ◽  
Cranial Fossa ◽  
Frontal Sinuses ◽  
Planum Sphenoidale ◽  
Brain Retraction

Olfactory groove meningiomas are benign tumors, which arise in the midline of the anterior cranial fossa, over the cribriform plate and frontosphenoid suture. They represent approximately 10 percent of all intracranial meningiomas, more likely to occur in women in the fifth and sixth decades of life. They often involve the area from the grista galli to the posterior planum sphenoidale, and can be either simetric, bilateral or unilateral based on their midline origin. We report the case of a 45-year-old man who presented with an episode of loss of consciousness, progressive mental disturbances, impairment of visual acuity, anosmia and headache. Gadolinium-enhanced T1-weighted MR images showed a well-defined, hyperintense mass, located in the anterior cranial fossa, measuring 45/50/61 mm, with homogenous enhancement and a broad dural attachment to the cribriform plate, from crista galli to the planum sphenoidale. Preoperative Angiography revealed tumor vascularization from anterior and posterior ethmoidal arteries, branches of ophthalmic artery and branches of external carotid artery. The olfactory groove meningioma was successfully resected using a bifrontal approach with frontal sinuses opened in order to avoid brain retraction. Cranialization with pericranium of frontal sinuses was performed at the end of surgical procedure. Improvement of visual acuity was noted, mental disturbances and seizures remitted, but cerebrospinal leakage occurred, resolved via recranialization of frontal sinuses and lumbar punctions. The last postoperative computer-tomography investigation showed total surgical removal with no recurrence or residual tumor. Total tumor removal must be performed with coagulation of its arachnoid attachments and resection of hyperostotic bone in order to avoid recurrence, but with least brain retraction.

scholarly journals Fulminant presentation of a SMARCB1-deficient, anterior cranial fossa tumor in adult

2020 ◽  
Vol 11 ◽  
pp. 195
Author(s):  
Idan Levitan ◽  
Suzana Fichman ◽  
Yosef Laviv
Keyword(s):  
Skull Base ◽  
Paranasal Sinuses ◽  
Anterior Skull Base ◽  
Anterior Cranial Fossa ◽  
Sinonasal Carcinoma ◽  
Rhabdoid Cells ◽  
Atypical Teratoid ◽  
Cranial Fossa ◽  
Rhabdoid Glioblastoma ◽  
Tumor Debulking

Background: Malignant atypical teratoid rhabdoid tumor (ATRT) usually develops in children. ATRTs are rare in adults, with only one case in the literature describing involvement of the anterior skull base. These primary intracranial tumors are characterized molecularly as SMARCB1 (INI1) deficient. Different types of such SMARCB1-deficient tumors exist in adulthood, usually in the form of extracranial tumors. Very few cases of such a new entity, named SMARCB1-deficient sinonasal carcinoma have been described with intracranial penetration and involvement of the anterior cranial fossa. Case Description: A 36-year-old male presented with acute cognitive deterioration. Over few hours, he developed a fulminant herniation syndrome. Imaging showed a tumor in the anterior cranial fossa surrounded by massive brain edema. The tumor has destroyed the frontal bone with involvement of the nasal cavities and paranasal sinuses. The patient underwent emergent decompressive craniectomy and tumor debulking but could not be saved. Pathological analysis revealed a highly cellular tumor without rhabdoid cells but with areas of necrosis. Further immunohistochemical stains revealed that neoplastic cells were diffusely and strongly positive for epithelial membrane antigen and P63 and negative for SMARCB1 (i.e., loss of expression), confirming the diagnosis of sinonasal carcinoma. Conclusion: To the best of our knowledge, this is the first report of a fulminant presentation of a SMARCB1- deficient tumor in young adult, involving the anterior cranial fossa and the paranasal sinuses. The main differential diagnosis of aggressive, primary, intracranial SMARCB1-deficient tumors in adults includes ATRT, SMARCB1- deficient sinonasal carcinoma, rhabdoid meningioma, and rhabdoid glioblastoma. Atypical tumors involving the anterior skull base without a clear histopathological pattern should therefore be checked for SMARCB1 expression.

scholarly journals Malignant Tumors of the Nose and Paranasal Sinuses: A Retrospective Review of 291 Cases

2001 ◽  
Vol 80 (4) ◽  
pp. 272-277 ◽  
Author(s):  
David Goldenberg ◽  
Avishai Golz ◽  
Milo Fradis ◽  
Dan Martu ◽  
Aviram Netzer ◽  
...  
Keyword(s):  
Retrospective Study ◽  
General Population ◽  
Paranasal Sinuses ◽  
Retrospective Review ◽  
Malignant Tumors ◽  
Malignant Neoplasms ◽  
Nose And Paranasal Sinuses ◽  
Romanian Population

Malignant neoplasms of the nose and paranasal sinuses are not common among the general population. We present a retrospective study of 291 cases of malignant tumors of the nose and paranasal sinuses that were diagnosed in a northern Romanian population over a period of 35 years. We review the etiology, diagnosis, prognosis, and treatment of these tumors.

Rhinotomy Approaches to the Paranasal Sinuses and Anterior Skull Base

1995 ◽  
Vol 112 (5) ◽  
pp. P63-P63
Author(s):  
William Lawson ◽  
Anthony J. Reino
Keyword(s):  
Skull Base ◽  
Paranasal Sinuses ◽  
Anterior Skull Base ◽  
Anterior Cranial Fossa ◽  
Malignant Diseases ◽  
Educational Objectives ◽  
Cranial Fossa

Educational objectives: To understand and apply the three rhinotomy approaches for extirpation of benign and malignant diseases of the sinonasal cavity, skull base, and anterior cranial fossa.

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