"Keystone" approach for intracranial nasofrontal dermoid sinuses.
Nasofrontal dermoid sinus tracts that extend intracranially through the foramen cecum or ethmoid can be difficult to completely resect. Complete extirpation of nasofrontal dermoid sinus cysts is essential for effective treatment of this problem to minimize the chance of recurrence. The authors describe a new technique based on parasagittal osteotomies through the supraorbital bar, or bandeau, that ensures that the resection of the nasofrontal dermoid sinus cysts is complete. This technique also limits the size of the external nasal incision and enhances the surgeon's exposure of the anterior cranial base for resection of intradural extension. This approach also enhances exposure for the direct repair of the dura and the cranial vault.
Division of Plastic Surgery, Department of Surgery, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana 46202-5200, USA.
John A
JA
van Aalst
Thomas G
TG
Luerssen
William E
WE
Whitehead
Robert J
RJ
Havlik
D002648:Child; D003399:Craniotomy / Q000379:methods*; D003884:Dermoid Cyst / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009361:Neoplasm Invasiveness; D009669:Nose Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D014057:Tomography, X-Ray Computed