• J E Zöller, R A Mischkowski, R Behr, R I Ernestus, and B Speder.
• Department of Oral and Maxillofacial Surgery, Medical Center University of Cologne, Köln, Germany.
• J Craniomaxillofac Surg. 2001 Jun 1;29(3):159-64.

IntroductionA combined extra-intracranial access for the operative exploration of tumours of the anterior and middle skull base is indicated when the tumour extends intracranially and simultaneously into the nasal cavity, the paranasal sinuses or the orbit.MethodsTwo standardized modifications of the fronto-orbital osteotomy, the fronto-orbito-nasal and the fronto-orbito-zygomatic osteotomy, allow safe removal of skull base tumours in these locations. In extensive skull base tumours, a modified bilateral fronto-orbital-zygomatic osteotomy can be used.ResultsBetween February 1993 and July 2000 skull base tumours in 111 patients were resected using the presented methods. The most frequent tumour type was meningioma in 29 cases. Complications were encountered in 13 cases (11.7%).ConclusionThe advantages over other approaches are good extra- and intracranial overview and minimal cerebral trauma. Additional transfacial incisions are not usually necessary. Exact repositioning of the fronto-orbital segments leads to optimal aesthetic results.

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