Transcranial approach for cancer of the antroethmoidal area

An improvement in the treatment results of antroethmoidal cancers may be achieved through the use of a transcranial approach, which makes an en bloc excision of the ethmoid labyrinths possible. This exposure allows dural involvement to be assessed, excised and repaired under direct vision. The technique used in the management of 9 patients is described. Eight of these patients presented with recurrent disease after previous radiotherapy and surgery. There were no deaths in the immediate postoperative period. Two patients are dead: one with disease in the frontal lobe; the other 18 months after operation, apparently free of disease. Facial deformity in patients who have undergone this operation is no greater than that associated with other operations in this area, and may be less, as a superior approach may allow the posterior ethmoidal and sphenoid area to be excised without orbital exenteration.