Modern Management of Anterior Skull Base Tumors

[Tactics of reconstructive closure of basal defects after resection of midline tumors of the anterior skull base (a literature review)]

The purpose of this review is to analyze the techniques used to reconstruct midline defects in the anterior skull base after transcranial and endoscopic endonasal resection of skull base tumors. We provide brief information on the technique for preparing various flaps, indications and contraindications, and advantages and disadvantages. We analyze the international experience in the use of vascularized and non-vascularized flaps as well as the existing algorithms for reconstruction of complex defects of the midline structures of the skull base. The literature data demonstrate the absence of a conventional tactics of reconstructive closure of the discussed defects. To resolve this issue, a meta-analysis in combination with an original prospective study is required.

[Choosing an anterior midline approach to skull base tumors]

The purpose of this review is to analyze used anterior midline approaches to the skull base, identify their advantages and disadvantages, and, after reviewing the literature data, submit a developed algorithm for choosing an optimal approach to the approval of colleagues. We provide brief information on approach techniques, indications and contraindications, and advantages and disadvantages as well as analyze international experience of using the discussed approaches. On the basis of literature data, we have developed a prototype algorithm for choosing an optimal approach to medial tumors of the anterior skull base. The situation of choosing an optimal approach reveals the absence of a clear understanding of the boundaries between capabilities and limitations of approaches. To solve this problem, an original prospective study is required.

Craniofacial approaches and reconstruction in skull base surgery: techniques for the oral and maxillofacial surgeon

Skull base surgery (SBS) is considered the standard of care in treating benign and malignant lesions of the cranial base. SBS is a multidisciplinary team approach used to treat these complex lesions that may have intracranial extension. SBS can be broken down into 3 steps. Transfacial access is performed, followed by resection with sound oncologic principles, and then reconstruction of the cranial base and facial structures. Functional and esthetic concerns must be addressed by the surgeons. Oral and maxillofacial surgeons frequently perform elective facial osteotomies and treat victims of cranial base trauma. These same principles can be applied to SBS as a part of the skull base team.

Olfactory colloid cyst: case report and review of extraventricular colloid cyst literature

OBJECTIVE

A rare case of an extraventricular colloid cyst located in the olfactory groove extending downward into the ethmoid sinus is presented. This is the second reported case in the world literature.

METHODS

A 56-year-old-woman presented with a lesion that was causing hyposmia and cerebrospinal fluid rhinorrhea. The lesion was an extraventricular colloid cyst displacing the left olfactory nerve downward and eroding into the left ethmoid sinus.

RESULTS

The lesion was excised, and the anterior skull base was reconstructed successfully via a unilateral subfrontal approach.

CONCLUSIONS

There were no complications, and the patient made a full recovery, with resolution of the cerebrospinal fluid rhinorrhea.