Preservation of the olfactory tract in bifrontal craniotomy for various lesions of the anterior cranial fossa

OBJECTIVE: Preservation of the olfactory tract during use of the bifrontal approach for the treatment of lesions located in the frontal cranial base a nd the supra- and parasellar regions has not been previously investigated. METHODS: In our study, 12 patients underwent surgery, via the basal subfron tal route, for treatment of various lesions. Ail patients were observed pro spectively, and olfactometry was performed pre- and postoperatively by an i ndependent otorhinolaryngologist. RESULTS: We obtained complete preservation of the olfactory tracts and norm al postoperative olfaction in ail 12 cases. CONCLUSION: The bifrontal approach yields a bilateral wide operative field with excellent orientation and views of important structures. The shortcomi ngs of this method, i.e., damage to the olfactory tracts and postoperative anosmia, can be overcome.