Anterior skull base surgery for benign and malignant disease.

Teamwork between the head and neck surgeon and the neurosurgeon utilizing the craniofacial resection technique greatly extends the frontiers of surgery for tumors of the anterior half of the skull base. Tumors for which this technique may be used include benign and malignant tumors arising in the frontal bone or frontal sinus, nasal vault, ethmoid, maxilla, sphenoid or orbit. Selected nasopharyngeal lesions such as angiofibromas with anterior or middle fossa extensions and sphenoid or clival chordomas may also be approached in this manner. This report evaluates the surgical techniques currently in use for managing these tumors, by discussing the benefits of combined resection, technical modifications of the techniques, and the results of using these techniques in 12 patients. The initial results are encouraging.