[The operation for malignant tumors in the frontal skull base: combined transbasal & transfacial approach]

The authors have previously reported on an extensive transbasal approach, through which a supraorbital bar is osteotomized. This operative technique has been applied by the authors not merely to benign but also to malignant tumors in the frontal skull base. However, in the operation for malignant tumors of the frontal base, it is important to resect en-bloc the tumors and surrounding tissues, such as dura of the skull base and the orbital contents. The authors describe the operative mode of the combined transbasal & transfacial approach and its good results in 19 cases with malignant tumors in the frontal skull base, and 3 types of en-bloc resection in this operative approach (from type A to C) are introduced. Type A of en-bloc resection in the combined transbasal & transfacial approach was performed in 11 cases with the tumors invading the ethmoid sinuses. Type B was performed in 4 cases with tumors extending to the orbit. Type C was performed in 4 cases with tumors extending to the orbit and the maxillary sinuses on the affected side. These operative modes are useful in skull base surgery.