Anterior craniofacial resection for ethmoid and nasal cancer with free flap reconstruction.

Two surgical approaches were used for nasal and ethmoid cancers involving the anterior skull base. A craniofacial operation with the assistance of a neurosurgeon was employed when the cribriform plate was infiltrated. A frontofacial operation through the frontal sinus was preferred when the cribriform plate was radiologically intact. Thirty patients underwent radical surgery with a minimum three-year follow-up. Thirteen of 16 patients with adenocarcinoma survived. Since 1980, nine patients have had their surgical defects repaired with a revascularized tensor fascia lata muscle and skin flap. The flap is tailored to support the cranial contents, provide muscle bulk for the orbitomaxillectomy cavity, and provide skin for the face, nasal, and palatal surfaces. There were two free flap failures.