eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Craniofacial Surgery
Anterior Subfrontal Approach - Tumor Removal: Multimedia
Updated: Jul 8, 2009
Multimedia
![]() | Media file 1: CT scan coronal view demonstrating an osteosarcoma of the ethmoid sinuses extending to the orbit and anterior cranial fossa. |
![]() | Media file 2: MRI axial view demonstrating extensive invasion of the frontal lobes by an adenocarcinoma. |
![]() | Media file 3: MRI sagittal view demonstrating invasion of the fontal lobes by an osteosarcoma. |
![]() | Media file 4: Markings for a bicoronal incision. |
![]() | Media file 5: Markings for a lateral rhinotomy incision. |
![]() | Media file 6: Intraoperative demonstration of a degloving approach. |
![]() | Media file 7: Exposure of the superior orbital rims and glabella. The supraorbital neurovascular bundles have been freed from their canal and are being retracted to facilitate the exposure. |
![]() | Media file 8: Craniotomy bone graft including the orbital rims and glabella as a monobloc. |
![]() | Media file 9: Craniotomy and supraorbital block removed as separate bone grafts. |
![]() | Media file 10: Surgical specimen after en bloc resection of anterior cranium, ethmoids, septum, and cribriform plate (posterior view). |
![]() | Media file 11: Neurosurgical view after bifrontal craniotomy. The osteotomies to remove the supraorbital block have been performed, but the rims are still in place. |
![]() | Media file 12: Neurosurgical view after the supraorbital rims and glabella have been removed, enhancing access to the cribriform plate area. |
![]() | Media file 13: Defect after resection of the cribriform plate. |
![]() | Media file 14: Elevation of a pericranial flap. |
![]() | Media file 15: Fixation of the cranial bone grafts with titanium adaptation plates. Titanium mesh is used to cover bone gaps caused by the loss of bone associated with the craniotomy. |
![]() | Media file 16: Reconstruction of the glabellar area using titanium mesh. |
![]() | Media file 17: CT scan axial view demonstrating a tension pneumocephalus. In the author's experience, this is the most common major complication after an anterior craniofacial resection. |
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Further Reading
Keywords
tumor removal, anterior subfrontal approach, tumor, anterior craniofacial resection, anterior cranial base surgery, anterior skull base surgery, tumor resection, anterior craniofacial resection, endoscopic anterior skull base surgery




































Multimedia: Anterior Subfrontal Approach - Tumor Removal