title: Combined transfacial and transcranial approach for tumours of the nose and paranasal sinuses with intracranial extension.
abstract: OBJECTIVE
  To describe the importance of craniofacial approach in extensive tumours of the nose and paranasal sinuses with intracranial extension.
  
  
  METHODS
  This is a retrospective study and descriptive analysis of craniofacial approaches to extensive tumors of the nose and paranasal sinuses that were carried at Usmanu Danfodiyo University Teaching Hospital, Sokoto Nigeria over a nine year period (July 1999 to June 2008).
  
  
  RESULTS
  Out of 111 patients seen with tumours of the nose and paranasal sinuses during the period, 29(26.1%) were radiologically reported through computerised tomographic scan to have intracranial extension. Twenty-four (82.8%) were males while 5 (17.2%) were females. Twenty-five (86.2%) patients underwent transfacial approach (modified lateral rhinotomy). Intraoperative findings in these cases only warranted the repair of dural tear in 6 cases through the transfacial approach who had anterior skull base invovlement while 4 had combined transcranial and transfacial approaches (anterior craniofacial resection). Therefore only 10 (34.5%) patients of all the radiologically reported cases of intracranial extension were confirmed intraoperatively to have intracranial extension (5 males, 5 females) with an age range of 1 1/2 to 60 years and mean age of 34.1 years. One patient had orbital exenteration also carried out. Four out of 10 patients are alive after a minimum period of 2 years follow up due to extensive intracranial spread and late presentation of the patient.
  
  
  CONCLUSIONS
  Extensive tumours of the nose and paranasal sinuses with suspected intracranial extension requires not only computerized tomographic scans to assess the extent of the tumour but also a combined transfacial and transcranial approach to successfully resect the tumour.
authors.affiliation: Dept. of Otorhinolaryngology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. frobih@yahoo.com
authors.forename: K R
authors.initials: KR
authors.lastname: Iseh
authors.forename: S B
authors.initials: SB
authors.lastname: Amutta
authors.forename: B B
authors.initials: BB
authors.lastname: Shehu
authors.forename: J
authors.initials: J
authors.lastname: Nasir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003399:Craniotomy; D005260:Female; D005500:Follow-Up Studies; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D009669:Nose Neoplasms / Q000473:pathology / Q000601:surgery*; D013506:Otologic Surgical Procedures; D010255:Paranasal Sinus Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D017678:Sex Distribution; D014057:Tomography, X-Ray Computed; D055815:Young Adult