Rm. Kellman et L. Marentette, The transglabellar/subcranial approach to the anterior skull base - A review of 72 cases, ARCH OTOLAR, 127(6), 2001, pp. 687-690
Objectives: To describe the transglabellar/subcranial approach to the anter
ior skull base and to compare it with more traditional approaches to cranio
facial resection.
Design: A retrospective analysis of 72 cases at 2 academic medical centers.
The main parameters analyzed were the disease entities treated, the averag
e operating room time, the average amount of blood loss, the number of tran
sfusions, the length of intensive care unit and hospital stays, and complic
ation rates. These were compared with published data for traditional cranio
facial approaches.
Setting: All patients were operated on by the authors in collaboration with
neurosurgical teams at the State University of New York Upstate Medical Un
iversity, Syracuse, and the University of Michigan Hospital, Ann Arbor.
Patients: The transglabellar/subcranial approach was performed 72 times in
69 patients in this series. Forty-two procedures in 40 patients were perfor
med for malignant disease and 30 procedures in 29 patients were performed f
or benign entities. Patients' ages ranged from 2 to 78 years. Follow-up ran
ged from 6 months to 4 years, with a minimum follow-up of 1 year for surviv
ors.
Results: There were no operative mortalities. Operating time, average amoun
t of blood loss, length of hospital and intensive care unit stays, and comp
lication rates compared favorably with published results of traditional cra
niofacial resections.
Conclusions: The transglabellar/subcranial approach to the anterior skull b
ase may be a reasonable technique for the surgical management of lesions in
the region of the anterior skull base. It provides excellent exposure of t
he nasal cavity, the orbits, and the ethmoid and sphenoid sinuses, while al
lowing wide access to the anterior fossa with a minimum amount of frontal l
obe retraction.