• Maria Peris Celda, Tyler Kenning, and Carlos D Pinheiro-Neto.
• Department of Neurosurgery, Albany Medical Center, Albany, New York, USA.
• World Neurosurg. 2017 Aug 1; 104: 311-317.

BackgroundTraditional endoscopic anterior cranial base resection involves the total removal of the ethmoidal cells, including the middle and superior turbinates. This is associated with increased volume of the nasal cavity postoperatively, with increased crusting and permanent change of the nasal airflow. Here we provide a step-by-step description of the technique and evaluate the feasibility of the superior ethmoidal approach for anterior cranial base resection with maximum exposure of the anterior cranial base while keeping the middle turbinates, uncinate processes, and ostiomeatal complexes intact.MethodsThree fresh cadaveric heads were used for dissections. This technique was successfully performed in 2 consecutive cases of large olfactory groove meningiomas.ResultsIn all anatomic dissections, satisfactory exposure of the cranial base was achieved while keeping the middle turbinate, uncinate process, ethmoid bulla, and middle meatus intact bilaterally. Successful resection of 2 consecutive cases of olfactory groove meningioma was performed using this approach.ConclusionsThe endoscopic superior ethmoidal approach for anterior cranial base resection is a feasible and safe approach that maximizes preservation of the nasal structures while providing optimal access to the anterior skull base. It can be used in pathologies that involve the anterior cranial base and do not involve the nasal structures.Copyright © 2017 Elsevier Inc. All rights reserved.

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