[Head and Neck Surgery Approach : Prelacrimal Approach, Direct Approach to the Anterior and Lateral Part of the...

In recent years, titles like "Direct Approach to the Anterior and Lateral Part of the Maxillary Sinus with an Endoscope (DALMA) " have become increasingly common at neurosurgery conferences. However, if DALMA is not performed correctly, external nasal deformities can occur. This section provides information to ensure that DALMA is performed safely and to help prevent complications. Next, the transcribriform approach is addressed. Since this study focuses on this approach, we describe the DRAF procedure and methods for crista galli resection. DRAF surgery, if not performed by surgeons with sufficient experience, may result in insufficient bone resection, thereby complicating surgical exposure. Furthermore, resection of the crista galli significantly improves the anterosuperior view, increases the mobility of the anterior skull base tissues, and ensures adequate working space. Here, we describe the surgical techniques developed or modified by the authors for these three approaches.