Commentary

I have been reading about transcranial approach for a variety of anterior skull base tumors since 1993. It can be supplemented by endoscopic inspection and resection through the resection cavity. Extensive invasion of the maxillary sinus, however, will necessitate a transfacial or degloving approach. If the patient has previously undergone irradiation or surgery, a radial forearm free flap, rather than just a pericranial flap, should be considered for reconstruction. This strategy may obviate the occurrence of postoperative infections.