AN EXTENSIVE SUBFRONTAL APPROACH TO THE LESIONS INVOLVING THE SKULL BASE

A modification of the transbasal approach of Dorome called extensive s ubfrontal approach and the surgical results with this approach in 22 c ases are presented. Bilateral frontal craniotomies incorporated with t he removal of orbital ridges and part of the orbital roofs were fashio ned en bloc. It may give rise to good exposure of the midline lesions of the anterior, middle and posterior skull base, minimizing the need for the retraction of frontal lobes. There was no surgical mortality i n this series of cases. Of the 20 cases with tumors, total resections were achieved in 11 cases, subtotal or large resections in 4 cases and partial resection in one case. Two patients with spontaneous rhinorrh ea were successively treated surgically. 21 patients had a follow-up w ith a time ranging from 1-11 years (a mean of 3 years). 15 patients re sumed their jobs with no evidence of recurrence of the original diseas e, and 5 patients able to live self-care. One patient with an olfactor y neuroblastoma died 3 years after the operation owing to relapse of t he tumor.