Chapter 25 - Endoscopic Craniofacial Resection

Abstract

An endoscopic craniofacial resection (CFR) can be considered in the management of benign and malignant tumors of the paranasal sinuses involving the skull base and may avoid the morbidity associated with an open CFR. A standard CFR combines a transfacial approach via a lateral rhinotomy or midface degloving to remove the sinus tumor components with a transcranial approach to remove the skull base and intracranial portions of the tumor. An endoscopic approach allows for a magnified view and increased illumination compared to a standard approach, especially in deep areas such as the pterygoid palatine fossa and the sphenoid sinus. The rate of postoperative CSF leak in endoscopic CFR is usually below 10%, and studies have found no difference in survival, metastatic, or complication rates between the two approaches.