Preservation of olfaction in anterior skull base surgery.
OBJECTIVE
In selected unilateral tumors and defects of the anterior skull base, the preservation of contralateral olfaction is achievable through a localized subcranial approach without compromising surgical objectives of resection or repair.


METHODS
Description of a functional adaptation of anterior skull base surgical techniques through a retrospective patient series.


METHODS
Nine patients underwent anterior skull base surgery for unilateral cribriform plate disease including four malignant and two benign tumors, two encephaloceles, and one iatrogenic cribriform injury with cerebrospinal rhinorrhea. All nine patients consented to a localized subcranial approach to the anterior skull base to preserve the contralateral olfactory nerves. In four patients with benign disease a portion of the ipsilateral nerves was additionally conserved. Postoperative olfaction was assessed objectively with a commercially available smell test. Indications, technique, results, and complications are reported and discussed.


RESULTS
All patients had eradication of disease with preservation of functional olfaction


CONCLUSIONS
Conservation of olfaction is possible in selected cases of anterior skull base surgery when the lesion is unilaterally confined.
Browne
J D
JD
Department of Otolaryngology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. jdbrowne@wfubmc.edu
Mims
J W
JW
D000230:Adenocarcinoma / Q000601:surgery; D000328:Adult; D000368:Aged; D004677:Encephalocele / Q000601:surgery*; D005004:Ethmoid Bone; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009447:Neuroblastoma / Q000601:surgery; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012903:Smell; D014057:Tomography, X-Ray Computed