The transglabellar/subcranial approach to the anterior skull base: a review of 72 cases.
OBJECTIVE
To describe the transglabellar/subcranial approach to the anterior skull base and to compare it with more traditional approaches to craniofacial resection.


METHODS
A retrospective analysis of 72 cases at 2 academic medical centers. The main parameters analyzed were the disease entities treated, the average operating room time, the average amount of blood loss, the number of transfusions, the length of intensive care unit and hospital stays, and complication rates. These were compared with published data for traditional craniofacial approaches.


METHODS
All patients were operated on by the authors in collaboration with neurosurgical teams at the State University of New York Upstate Medical University, Syracuse, and the University of Michigan Hospital, Ann Arbor.


METHODS
The transglabellar/subcranial approach was performed 72 times in 69 patients in this series. Forty-two procedures in 40 patients were performed for malignant disease and 30 procedures in 29 patients were performed for benign entities. Patients' ages ranged from 2 to 78 years. Follow-up ranged from 6 months to 4 years, with a minimum follow-up of 1 year for survivors.


RESULTS
There were no operative mortalities. Operating time, average amount of blood loss, length of hospital and intensive care unit stays, and complication rates compared favorably with published results of traditional craniofacial resections.


CONCLUSIONS
The transglabellar/subcranial approach to the anterior skull base may be a reasonable technique for the surgical management of lesions in the region of the anterior skull base. It provides excellent exposure of the nasal cavity, the orbits, and the ethmoid and sphenoid sinuses, while allowing wide access to the anterior fossa with a minimum amount of frontal lobe retraction.
Kellman
R M
RM
Department of Otolaryngology, State University of New York Upstate Medical University, Syracuse, USA.
Marentette
L
L
D000230:Adenocarcinoma / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D018304:Esthesioneuroblastoma, Olfactory / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009296:Nasal Cavity; D009669:Nose Neoplasms / Q000601:surgery; D013517:Otorhinolaryngologic Surgical Procedures; D010255:Paranasal Sinus Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D019291:Skull Base / Q000601:surgery*