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Anterior Skull Base Tumour. The Choice Between Cranial and Facial Approaches, Single and Combined Procedure. From a Series of 78 Cases

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Processes of the Cranial Midline

Part of the book series: Acta Neurochirurgica Supplementum ((NEUROCHIRURGICA,volume 53))

Summary

In order to define the most adequate surgical procedure to apply on anterior skull base lesions, we reviewed 78 cases of either benign (43 cases) or malignant (35 cases) tumours; they were treated either by a single surgical approach including transfacial approach (TF) in 9 cases, transbasal approach (TB) in 15 cases and fronto-orbital ridge deposition (FORD) in 16 cases or by a combined procedure: TB + TF (28 cases), TB + FORD (10 cases). In 7 cases, a pterional approach was associated to one of these combined procedures.

A classification is proposed, based on the tumour extension along the anteroposterior axis: I) anterior to the crista galli; II) anterior to the anterior clinoïd process; III) posterior to the anterior clinoid process; and along the vertical axis A: below the bone level; B: below the dura level; C: at and above the dura level. This classification appears very useful to choose among the surgical procedures which one is the more appropriate. In type A tumour (N = 8), TF is sufficient while in type B (N = 38) and C (N = 32) a cranial route is always necessary; among the latter, a combined procedure is frequently asked for posterior tumours type II (N = 29) and III (N = 24). However, others parameters such as tumour consistency, vascularization and need for en-bloc removal are also relevant in this choice

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Authors and Affiliations

  1. Department of Neurosurgery, Hôpital Lariboisiere, Paris, France

    Dr. B. George, S. Clemenceau, J. Cophignon, K. L. Mourier & G. Lot

  2. Department of Otorhinolaryngology, Hôpital Lariboisiere, Paris, France

    P. Tran ba Huy

  3. Department of Otorhinolaryngology, Institut G. Roussy, Villejuif, France

    B. Luboinski

Authors
  1. Dr. B. George
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  2. S. Clemenceau
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  3. J. Cophignon
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  4. P. Tran ba Huy
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  5. B. Luboinski
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  6. K. L. Mourier
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  7. G. Lot
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Editor information

Editors and Affiliations

  1. Department of Neurosurgery, University of Vienna Medical School, Vienna, Austria

    Wolfgang Koos  & Bernd Richling  & 

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© 1991 Springer-Verlag

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George, B. et al. (1991). Anterior Skull Base Tumour. The Choice Between Cranial and Facial Approaches, Single and Combined Procedure. From a Series of 78 Cases. In: Koos, W., Richling, B. (eds) Processes of the Cranial Midline. Acta Neurochirurgica Supplementum, vol 53. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9183-5_2

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  • DOI: https://doi.org/10.1007/978-3-7091-9183-5_2

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-9185-9

  • Online ISBN: 978-3-7091-9183-5

  • eBook Packages: Springer Book Archive

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