Olfactory Preservation in Craniofacial Resection of Tumor Invading Hemianterior Skull Base: Operative Video

Kenya Kobayashi; Yasuji Miyakita; Fumihiko Matsumoto; Go Omura; Satoko Matsumura; Atsuo Ikeda; Kohtaro Eguchi; Akiko Ito; Yoshitaka Narita; Satoshi Akazawa; Seiichi Yoshimoto

doi:10.1055/s-0041-1727123

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

CC BY-NC-ND 4.0 · J Neurol Surg B Skull Base 2022; 83(S 03): e639-e640
DOI: 10.1055/s-0041-1727123

Skull Base: Operative Videos

Olfactory Preservation in Craniofacial Resection of Tumor Invading Hemianterior Skull Base: Operative Video

Authors

Kenya Kobayashi

¹Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
Yasuji Miyakita

²Department of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan
Fumihiko Matsumoto

¹Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
Go Omura

¹Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
Satoko Matsumura

¹Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
Atsuo Ikeda

¹Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
Kohtaro Eguchi

¹Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
Akiko Ito

¹Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
Yoshitaka Narita

²Department of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan
Satoshi Akazawa

³Department of Plastic and Reconstructive surgery, National Cancer Center Hospital, Tokyo, Japan
Seiichi Yoshimoto

¹Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan

Abstract

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Keywords

olfactory preservation - craniofacial resection - hemianterior skull base - ethmoid sinus - craniotomy

Fig. 1 Preoperative axial (A) and coronal (B) T2-weighted magnetic resonance images demonstrating a 2 cm × 2 cm × 2 cm well-circumscribed tumor invading the ipsilateral cribriform plate, dura menta, and orbital periosteum; the nasal septum was intact. Postoperative axial (C) and coronal (D) computed tomographic images demonstrating that the tumor was completely resected and the left olfactory apparatus (epithelium, cribriform plate, and olfactory bulb) were spared.

Fig. 2 The scheme of surgical resection is shown (A). Purple arrow indicates the line of dissection in the transcranial approach. Red arrow indicates the line of dissection line in the transfacial approach. A, eyeball; B, extraocular muscle; C, orbital periosteum; D, septum mucosa; E, septum cartilage; F, olfactory bulb; G, crista galli; H, dura mater; I, brain; J, tumor. (B) Intraoperative image showing the midline of the cribriform plate and the perpendicular plate of the ethmoid bone were drilled via craniotomy, and (C) the right septal mucosa were detached through the transfacial approach.

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Figures

Fig. 1 Preoperative axial (A) and coronal (B) T2-weighted magnetic resonance images demonstrating a 2 cm × 2 cm × 2 cm well-circumscribed tumor invading the ipsilateral cribriform plate, dura menta, and orbital periosteum; the nasal septum was intact. Postoperative axial (C) and coronal (D) computed tomographic images demonstrating that the tumor was completely resected and the left olfactory apparatus (epithelium, cribriform plate, and olfactory bulb) were spared.

Fig. 2 The scheme of surgical resection is shown (A). Purple arrow indicates the line of dissection in the transcranial approach. Red arrow indicates the line of dissection line in the transfacial approach. A, eyeball; B, extraocular muscle; C, orbital periosteum; D, septum mucosa; E, septum cartilage; F, olfactory bulb; G, crista galli; H, dura mater; I, brain; J, tumor. (B) Intraoperative image showing the midline of the cribriform plate and the perpendicular plate of the ethmoid bone were drilled via craniotomy, and (C) the right septal mucosa were detached through the transfacial approach.