Control of complications in the midfrontobasal approach

Many surgical techniques are employed for access to midline lesions of the anterior and middle fossa. A convenient one is the midfrontobasal approach. For various indications this surgical procedure was performed in 105 patients. Its benefits are outlined and a method for dealing with the two main drawbacks, postoperative loss of the sense of smell and the presumed risk of infection related to the inevitable opening of the frontal sinus, are described. In 83% of the cases the authors were able to anatomically retain the olfactory nerves, with preservation of the sense of smell in at least 65% of them. The frontal sinus was opened in 76% of the cases. The incidence of infection in the simple and quick integral reconstruction appeared 1%, equal to the rate of infection in the classical reduction of the frontal sinus by a periosteal flap.