Traditional craniofacial resection

Tumors of the sinonasal region and anterior skull base present diagnostic and surgical challenges. Access to and exposure of the tumor tends to be difficult because of the delicate neurovascular structures that occupy this area, including the brain and the orbital contents. The diagnosis and treatment of tumors in this region have improved with advances in diagnostic imaging, anesthesia, surgical navigation, and regional and free-tissue reconstruction. Unfortunately, due to the insidious onset and progression of vague symptoms, patients usually present with advanced disease. Craniofacial approaches are designed to improve tumor exposure permitting complete resection of large tumors that would otherwise be very difficult to resect from an isolated approach. The aim of this article is to describe both the surgical approaches and methods of resection for tumor of the anterior skull base.