Preservation of olfaction in anterior skull base surgery

Objectives/Hypothesis: In selected unilateral tumors and defects of the ant erior skull base, the preservation of contralateral olfaction is achievable through a localized subcranial approach without compromising surgical obje ctives of resection or repair. Study Design: Description of a functional ad aptation of anterior skull base surgical techniques through a retrospective patient series. Methods: Nine patients underwent anterior skull base surge ry for unilateral cribriform plate disease including four malignant and two benign tumors, two encephaloceles, and one iatrogenic cribriform injury wi th cerebrospinal rhinorrhea. All nine patients consented to a localized sub cranial approach to the anterior skull base to preserve the contralateral o lfactory nerves. In four patients with benign disease a portion of the ipsi lateral nerves was additionally conserved. Postoperative olfaction was asse ssed objectively with a commercially available smell test. Indications, tec hnique, results, and complications are reported and discussed. Results: AU patients had eradication of disease with preservation of functional olfacti on Conclusions: Conservation of olfaction is possible in selected cases of anterior skull base surgery when the lesion is unilaterally confined.