The expanded endonasal approach for the treatment of anterior skull base tumors

Traditional approaches for the resection of tumors that involve the anterior cranial base used facial and scalp incisions, a craniotomy, and facial osteotomies. These approaches required frontal lobe retraction and sometimes resulted in cosmetic and functional deficits. With the advances in optics, surgical instrumentation, and image-guided surgery, the expanded endonasal approach (EEA) has provided a less intrusive corridor to the anterior skull base without compromising the goals of oncological resection. Our extensive experience with this approach has enabled us to perform a “craniofacial resection” for anterior skull base tumors without resorting to external incisions or a craniotomy. This report details the operative technique for a completely endoscopic endonasal resection of the anterior skull base that may be used for the resection of both benign and malignant tumors.