Surgery of Extracerebral Tumors of the Frontal and Medial Skull Base

Abstract

Of the seven approaches that allow access to the frontal and medial skull base, the transnasal-transethmoidal has gained worldwide acceptance in surgery of intrasellar tumors of the pituitary gland. It is commonly used by neurosurgeons, as is the transfrontal-transbasal approach. The transethmoid access is mainly used by ENT surgeons, whereas both the transoral and the unilateral transmaxillary approach are often used by maxillofacial and ENT surgeons. The transcervical approach provides access only to the lower half of the clivus (Derome 1983). In the treatment of tumors invading the frontal medial skull base from the dorsal wall of the frontal sinus, access to the skull base is provided by the tumor itself.