Skull base surgery: Access to anterior and middle cranial fossa.

ABSTRACT

Although skull base lesions, which differ in comparison to other areas of pathology, are difficult to deal with, much has been published of the subject in the last two decades. Access, visualization, surgical skill, and technique are keys of surgical success. Since June 1995 – December 1996, 47 cases were performed by the basal skull group; (neurosurgeon, ENT, ophthalmic and plastic surgeons). Among these cases, 28 fronto-orbito-zygotomies were performed for anterior and middle cranial fossa lesions including tumors of the cavernous sinus, vascular aneurysms and orbital tumours, etc. Most benign lesions were totally removed and functional preservation was achieved in most cases. Only one case of morbidity from injury to the frontal nerve and two mortalities from intracerebellar haemorrage and sepsis occurred. Access is the major crucial factor which can determine the functional result, and involvement of multidisciplinary fields will provide good cosmetic results.