Anterior, antero-lateral and trans-oral combined approaches to the skull base

G. Giuliani, F. Spallaccia, M. Massarelli, G. Maira

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Objectives: In neoplastic pathologies concerning the anterior and middle skull base we have observed over the past five years, surgical approaches performed together with the Department of Neurosurgery have been applied in 52 cases. Methods: Anterior, antero-lateral and trans-oral approaches were used. The most frequent approach was that which involved an extended fronto-orbital opening, depending on the anatomical site of the pathology, to the nasal bone, the zygomatic bone, to the lateral orbital wall and to the temporo-parietal bone. In 5 cases trans-oral openings were used, such as LeFort I combined with or without palatal bipartition. The reconstruction of the base was performed using pericrania! flaps or temporal muscle. In the case of extensive defects, continuity was restored by a transplantation of calvarian bone. Results: The fixation of the bone windows carried out by means of mini and micro plates gave good results in stabilization and osteointegration. The restitution of cranio-facial eurhytmia was optimum. Conclusions: The collaboration between the two surgical équipes allowed a combined approach permitting a better dominion of the lesion, better radicality and minor cerebral divarication.

Original languageEnglish
Pages (from-to)16
Number of pages1
JournalSkull Base Surgery
Issue numberSUPPL. 2
Publication statusPublished - 1999

ASJC Scopus subject areas

  • Clinical Neurology


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