ABSTRACT
The transbasal approach offers extradural exposure of the anterior midline skull base
transcranially. It can be used to treat a variety of conditions, including trauma,
craniofacial deformity, and tumors. This approach has been modified to enhance basal
access. This article reviews the principle differences among modifications to the
transbasal approach and introduces a new classification scheme. The rationale is to
offer a uniform nomenclature to facilitate discussion of these approaches, their indications,
and related issues.
KEYWORDS
Frontal fossa - skull base - subcranial - subfrontal - transbasal
REFERENCES
1
Beals S P, Joganic E.
Transfacial exposure of anterior cranial fossa and clival tumors.
BNI Q.
1992;
8
2-18
2
Raso J L, Gusmäo S.
Transbasal approach to skull base tumors: evaluation and proposal of classification.
Surg Neurol.
2006;
65(suppl 1)
S1:33-S1:37
discussion 1:37-1:38
3 Dandy W E. Orbital Tumors: Results Following the Transcranial Operative Attack. New
York; Oskar Piest 1941
4
Unterberger S.
Care of frontobasal wounds [in German].
Arch Ohren Nasen Kehlkopfheilkd.
1958;
172
463-484
5
Tessier P, Guiot G, Derome P.
Orbital hypertelorism: II. Definite treatment of orbital hypertelorism (OR.H.) by
craniofacial or by extracranial osteotomies.
Scand J Plast Reconstr Surg.
1973;
7
39-58
6
Tessier P, Guiot G, Rougerie J, Delbet J P, Pastoriza J.
Cranio-naso-orbito-facial osteotomies: hypertelorism. [in French].
Ann Chir Plast.
1967;
12
103-118
7
Tessier P.
Orbital hypertelorism: I. Successive surgical attempts. Material and methods. Causes
and mechanisms.
Scand J Plast Reconstr Surg.
1972;
6
135-155
8
Ketcham A S, Wilkins R H, Van Buren J M, Smith R R.
A combined intracranial facial approach to the paranasal sinuses.
Am J Surg.
1963;
106
698-703
9
Smith R R, Klopp C T, Williams J M.
Surgical treatment of cancer of the frontal sinus and adjacent areas.
Cancer.
1954;
7
991-994
10
Ketcham A S, Hoye R C, Van Buren J M, Johnson R H, Smith R R, Anderson M.
Complications of intracranial facial resection for tumors of the paranasal sinuses.
Am J Surg.
1966;
112
591-596
11
Van Buren J M, Ommaya A K, Ketcham A S.
Ten years' experience with radical combined craniofacial resection of malignant tumors
of the paranasal sinuses.
J Neurosurg.
1968;
28
341-350
12
Ketcham A S, Van Buren J M.
Tumors of the paranasal sinuses: a therapeutic challenge.
Am J Surg.
1985;
150
406-413
13 Derome P J.
The transbasal approach to tumors invading the base of the skull . In: Schmidek HH, Sweet WH Operative Neurosurgical Techniques: Indications, Methods,
and Results. Boston; Grune & Stratton 1982: 357-379
14
Converse J M, Ransohoff J, Mathews E S, Smith B, Molenaar A.
Ocular hypertelorism and pseudohypertelorism: advances in surgical treatment.
Plast Reconstr Surg.
1970;
45
1-13
15
Spetzler R F, Herman J M, Beals S, Joganic E, Milligan J.
Preservation of olfaction in anterior craniofacial approaches.
J Neurosurg.
1993;
79
48-52
16
Feiz-Erfan I, Han P P, Spetzler R F et al..
Preserving olfactory function in anterior craniofacial surgery through cribriform
plate osteotomy applied in selected patients.
Neurosurgery.
2005;
57
86-93
discussion 86-93
17
Lang D A, Honeybul S, Neil-Dwyer G, Evans B T, Weller R O, Gill J.
The extended transbasal approach: clinical applications and complications.
Acta Neurochir (Wien).
1999;
141
579-585
18
Saito K, Takahashi M, Fukuta K, Tachibana E, Yoshida J.
Recovery of olfactory function after an anterior craniofacial approach.
Skull Base Surg.
1999;
9
201-206
19
Kawauchi M, Tomita S, Asari S, Ohmoto T.
Preservation of olfaction in frontal transbasal approach. [in Japanese].
No Shinkei Geka.
1997;
25
613-619
20
Raveh J, Turk J B, Ladrach K et al..
Extended anterior subcranial approach for skull base tumors: long term results.
J Neurosurg.
1995;
82
1002-1010
21
Brahma B, Gunnlaugsson C, Gala V, Marentette B L, Thompson B G.
Treatment of ethmoidal and medial-anterior cranial base pathology using the subcranial
approach with attempted preservation of olfaction: outcome in 17 patients [abstract].
Skull Base.
2003;
13(suppl 1)
6
22
Browne J D, Mims J W.
Preservation of olfaction in anterior skull base surgery.
Laryngoscope.
2000;
110
1317-1322
23
Terasaka S, Day J D, Fukushima T.
Extended transbasal approach: anatomy, technique, and indications.
Skull Base Surg.
1999;
9
177-184
24
Feiz-Erfan I, Han P P, Spetzler R F et al..
Experience with the radical transbasal approach in resection of extensive benign anterior
skull base tumors [abstract].
Skull Base.
2003;
13(suppl 1)
6
25
Feiz-Erfan I, Han P P, Spetzler R F et al..
Exposure of midline cranial base without a facial incision through a combined craniofacial-transfacial
procedure.
Neurosurgery.
2005;
56
28-35
26
George B, Clemenceau S, Cophignon J et al..
Anterior skull base tumour: the choice between cranial and facial approaches, single
and combined procedure-from a series of 78 cases.
Acta Neurochir Suppl (Wien).
1991;
53
7-13
27
Spetzler R F, Pappas C T.
Management of anterior skull base tumors.
Clin Neurosurg.
1991;
37
490-501
28
Arita N, Mori S, Sano M et al..
Surgical treatment of tumors in the anterior skull base using the transbasal approach.
Neurosurgery.
1989;
24
379-384
29
Osguthorpe J D, Patel S.
Craniofacial approaches to sinus malignancy.
Otolaryngol Clin North Am.
1995;
28
1239-1257
30
Fujitsu K, Saijoh M, Aoki F et al..
Telecanthal approach for meningiomas in the ethmoid and sphenoid sinuses.
Neurosurgery.
1991;
28
714-719
31
Honeybul S, Neil-Dwyer G, Lang D A, Evans B T, Weller R O, Gill J.
The extended transbasal approach: a quantitative anatomical and histological study.
Acta Neurochir (Wien).
1999;
141
251-259
32
Cophignon J, George B, Marchac D, Roux F.
Enlarged transbasal approach by mobilization of the medial fronto-orbital ridge.
Neurochirurgie.
1983;
29
407-410
33
Feiz-Erfan I, Han P P, Spetzler R F et al..
The radical transbasal approach for resection of anterior and midline skull base lesions.
J Neurosurg.
2005;
103
485-490
34
Pompili A, Caroli F, Iandolo B, Mazzitelli M R, Riccio A.
Giant osteoma of the sphenoid sinus reached by an extradural transbasal approach:
case report.
Neurosurgery.
1985;
17
818-821
35
Jane J A, Park T S, Pobereskin L H, Winn H R, Butler A B.
The supraorbital approach: technical note.
Neurosurgery.
1982;
11
537-542
36
Morioka M, Hamada J, Yano S et al..
Frontal skull base surgery combined with endonasal endoscopic sinus surgery.
Surg Neurol.
2005;
64
44-49
37
Fliss D M, Zucker G, Cohen A et al..
Early outcome and complications of the extended subcranial approach to the anterior
skull base.
Laryngoscope.
1999;
109
153-160
38
Kellman R M, Marentette L.
The transglabellar/subcranial approach to the anterior skull base: a review of 72
cases.
Arch Otolaryngol Head Neck Surg.
2001;
127
687-690
39 Samii M, Draf W.
Surgery of space-occupying lesions of the anterior skull base . In: Samii M, Draf W Surgery of the Skull Base: An Interdisciplinary Approach. New
York; Springer-Verlag 1989: 159-232
40
Alvarez-Garijo J A, Cavadas P, Vila M, Fabregat J, Alvarez A.
Craniopharyngioma in children: surgical treatment by a transbasal anterior approach.
Childs Nerv Syst.
1998;
14
709-712
41
Liu J K, Decker D, Schaefer S D et al..
Zones of approach for craniofacial resection: minimizing facial incisions for resection
of anterior cranial base and paranasal sinus tumors.
Neurosurgery.
2003;
53
1126-1137
42
Sekhar L N, Nanda A, Sen C N, Snyderman C N, Janecka I P.
The extended frontal approach to tumors of the anterior, middle, and posterior skull
base.
J Neurosurg.
1992;
76
198-206
43
Kurtsoy A, Menku A, Tucer B et al..
Transbasal approaches: surgical details, pitfalls and avoidances.
Neurosurg Rev.
2004;
27
267-273
44
Tzortzidis F, Bejjani G, Papadas T et al..
Craniofacial osteotomies to facilitate resection of large tumours of the anterior
skull base.
J Craniomaxillofac Surg.
1996;
24
224-229
45 Sekhar L N, Wright D C.
Resection of anterior, middle, and posterior cranial base tumors via the extended
subfrontal approach . In: Sekhar LN, deOliveira E Cranial Microsurgery: Approaches and Techniques. New
York; Thieme 1999: 82-90
46
Moore C E, Ross D A, Marentette L J.
Subcranial approach to tumors of the anterior cranial base: analysis of current and
traditional surgical techniques.
Otolaryngol Head Neck Surg.
1999;
120
387-390
47
Obeid F, Al Mefty O.
Recurrence of olfactory groove meningiomas.
Neurosurgery.
2003;
53
534-542
48
Fahlbusch R, Neubauer U, Wigand M et al..
Neuro-rhinosurgical treatment of aesthesioneuroblastoma.
Acta Neurochir (Wien).
1989;
100
93-100
49
Zhou L, Guo H, Li S, Ji Y, Huang F.
An extensive subfrontal approach to the lesions involving the skull base.
Chin Med J (Engl).
1995;
108
407-412
50
Maroon J C, Kennerdell J S.
Microsurgical approach to orbital tumors.
Clin Neurosurg.
1979;
26
479-489
51
Kawakami K, Yamanouchi Y, Kubota C, Kawamura Y, Matsumura H.
An extensive transbasal approach to frontal skull-base tumors: technical note.
J Neurosurg.
1992;
74
1011-1013
52
Shen J, Hu J, Hu B et al..
Extensive transbasal approach for removal of tumours in the nasal, sphenoid and clival
regions [in Chinese].
Zhonghua Wai Ke Za Zhi.
1999;
37
35-37
53
Delfini R, Missori P, Iannetti G, Ciappetta P, Cantore G.
Mucoceles of the paranasal sinuses with intracranial and intraorbital extension: report
of 28 cases.
Neurosurgery.
1993;
32
901-906
54
DeMonte F.
The Chandler/Silva article reviewed.
Oncology (Williston Park).
2005;
19
923
55
Shah J P, Kraus D H, Bilsky M H, Gutin P H, Harrison L H, Strong E W.
Craniofacial resection for malignant tumors involving the anterior skull base.
Arch Otolaryngol Head Neck Surg.
1997;
123
1312-1317
56
Hallacq P, Moreau J-J, Fischer G, Béziat J-L.
Trans-sinusal frontal approach for olfactory groove meningiomas.
Skull Base.
2001;
11
35-46
57
Persing J A, Jane J A, Levine P A, Cantrell R W.
The versatile frontal sinus approach to the floor of the anterior cranial fossa: technical
note.
J Neurosurg.
1990;
72
513-516
58
Kaplan M J, Jane J A, Park T S, Cantrell R W.
Supraorbital rim approach to the anterior skull base.
Laryngoscope.
1984;
94
1137-1139
59
Lesoin F, Thomas III C E, Villette L, Pellerin P, Jomin M.
The midline supra-orbital approach, using a large single free bone flap: technical
note.
Acta Neurochir (Wien).
1987;
87
86-89
60
Chandler J P, Pelzer H J, Bendok B B, Hunt B H, Salehi S A.
Advances in surgical management of malignancies of the cranial base: the extended
transbasal approach.
J Neurooncol.
2005;
73
145-152
61
Chandler J P, Silva F E.
Extended transbasal approach to skull base tumors: technical nuances and review of
the literature.
Oncology (Williston Park).
2005;
19
913-919
62
Raimondi A J, Gutierrez F A.
A new surgical approach to the treatment of coronal synostosis.
J Neurosurg.
1977;
46
210-214
63
Jakumeit H D.
Neuroblastoma of the olfactory nerve.
Acta Neurochir (Wien).
1971;
25
99-108
64
Blacklock J B, Weber R S, Lee Y Y, Goepfert H.
Transcranial resection of tumors of the paranasal sinuses and nasal cavity.
J Neurosurg.
1989;
71
10-15
65
McCutcheon I E, Blacklock J B, Weber R S et al..
Anterior transcranial (craniofacial) resection of tumors of the paranasal sinuses:
surgical technique and results.
Neurosurgery.
1996;
38
471-479
66
Ross D A, Marentette L J, Moore C E, Switz K L.
Craniofacial resection: decreased complication rate with a modified subcranial approach.
Skull Base Surg.
1999;
9
95-101
67
Ohnishi T, Mori S, Arita N.
Primary meningioma of paranasal sinuses treated by the transbasal approach.
Surg Neurol.
1987;
27
195-199
68
Pinsolle J, San-Galli F, Siberchicot F, Caix P, Emparanza A, Michelet F X.
Modified approach for ethmoid and anterior skull base surgery.
Arch Otolaryngol Head Neck Surg.
1991;
117
779-782
69
Fukuta K, Saito K, Takahashi M, Torii S.
Surgical approach to midline skull base tumors with olfactory preservation.
Plast Reconstr Surg.
1997;
100
318-325
70
Malecki J.
New trends in frontal sinus surgery.
Acta Otolaryngol.
1959;
50
137-140
71
Housepian E M.
Surgical treatment of unilateral optic nerve gliomas.
J Neurosurg.
1969;
31
604-607
72
Love J G, Bryar G E.
Transcranial extirpation of orbital tumors.
Trans Am Acad Ophthalmol Otolaryngol.
1966;
70
620-626
73
Johns M E, Kaplan M J.
Surgical approach to the anterior skull base.
Ear Nose Throat J.
1986;
65
117-124
Iman Feiz-ErfanM.D.
c/o Neuroscience Publications, Barrow Neurological Institute
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Email: neuropub@chw.edu