Frontal trans-sinusal approach: how I do it

Anterior skull base lesions could be reached by different approaches (subfrontal, pterional, interhemispheric, etc.). In selected cases, the frontal trans-sinusal approach is an effective alternative to conventional techniques.

We present our technique to perform a frontal trans-sinusal approach in a patient affected by a large olfactory groove meningioma.

The frontal trans-sinusal approach allows to approach safely lesions of the median anterior cranial fossa. This approach provides lower brain retraction, easier access to olfactory grooves, and earlier tumor devascularization. However, it remains limited to patients with large-sized frontal sinuses and entails some postoperative risks such as mucocele or CSF leak.