Anterior cranial fossa resection : a new dimension in skull base surgery : a perspective study of 30 cases

Thirty patients with nasal and paranasal sinus lesion involving anterior cranial fossa, underwent craniofacial resection over a three year period were analysed. Nasal mass causing obstruction was the most frequently encountered symptom. Half of the patients had either unilateral or bilateral proptosis. A similar number had history of visual deterioration. Ocular nerve palsies were recorded in over a third of the cases. All the patients had CT scans of Head along with coronal cuts for anterior cranial fossa. A wide range of lesions were encountered, which included malignant lesions in 20 (66 percent) patients, 2 patients had extensive fibrous dysplasia of the sphenoethmoid complex and 3 patients had large osteomas of the anterior skull base. Mucarmycosis, aneurysmal bonecyst, and miningioma were noticed one case each. Two patients had giant cell tumour. Anterior cranial fossa floor was radically excised, posteriorly up to tuberculum orbits. In 9 patients orbital exenteration was also carried out. Total maxillectomy and partial medical maxillectomy was carried out in 8 cases each. Patients had a good cosmetic results, thus justifying the need for extensive cranio facial resection.