Reconstruction of anterior skull base after craniofacial resection

Anterior craniofacial resection and reconstruction surgeries were per formed upon 21 patients [13 females and 8 males] aged 12-72 years, at the period between 1996-2002 at Mansoura University Hospital, Department of ORL Head and Neck surgery. Surgeries were performed for nasal and paranasal sinus malignant tumors with cranial and/or intracranial extention. Various forms of anterior cranial base reconstruction strategies were used in our work, anteriorly pedicled galeal pericranial flap, galeal- pericranial flap+ skin graft, galeal pericranial flap + calvarial bone graft, and galeal-pericranial flap+ temporal is osteo muscular flap. Orbital exenteration was done for two patients with ethmoidal undifferentiated carcinoma and obliteration of the orbit was done using pedicled temporalis muscle flap. Subtotal maxillectomy [18 cases], and total maxillectomy [3 cases] were per- formed. We described the technique of the resection and the reconstruction with evaluation of reconstruction results. Our objective is to evaluate the clinical outcome of our technique in resection and reconstruction of anterior skull base. We concluded that Knowledge's about different methods of reconstruction after craniofacial resection enabled the skull base surgeons to extend their resections in or der to increase the safety margin. Also we found that the pericranial flap is the most ideal and reliable method for reconstruction of skull base after resection. Rigid bony reconstruction can be used in cases where the resection of anterior skull base was extended laterally to involve the orbital roof

Management of juvenile angiofibroma with intracranial extension

This study included 19 patients with angiofibromas with variable degrees of intracranial extension. Of those, patients with minimal intracranial-extradural extension [Fisch class IIIb] were managed through transmaxillary subcranial approach, while extensive intracranial extension [Fisch class IV] necessitated combined craniofacial approach through frontotemporal craniotomy with maxillary removal and reinsertion. The hospital stay, the blood loss, the operative time accessibility and complications of each approach were evaluated