Endoscopic glabellar approach to the anterior skull base: a technical note.

Abstract

An endoscopic glabellar transethmoidal approach via a small nasional incision to the anterior skull base is reported as a minimally invasive neurosurgical technique. A frontonasal craniotomy (2 x 2 cm in size) between the medial orbits is made via a nasional skin incision approximately 3-cm in length. An ethmoidectomy is performed in order to expose the skull base at the anterior cranial fossa. Anterior and posterior ethmoidal arteries, which provide blood-supply to the tumor, are interrupted during the ethmoidectomy. The tumor located at the anterior cranial fossa is removed under an endoscope. A rod-lens endoscope, which is 4-mm in diameter and 18-cm in length, is used. The dura mater is reconstructed with dural graft placement. The skull-base bone at the anterior cranial fossa is reconstructed with autogenous bone or a piece of titanium mesh. The ethmoidectomy site is filled with abdominal fat graft material. The craniotomy bone flap is secured with titanium microplates and screws. Two demonstrative patients are reported. The benefits of the minimally invasiveness of this surgical technique have been observed in patient recovery. An endoscopic glabellar transethmoidal approach to the anterior cranial fossa via a small nasional incision is reported with two patients with olfactory groove meningiomas.