Abstract
The authors have previously reported on an operative mode, termed an 'extensive transbasal approach', for lesions in the frontal base, through which an osteotomized supraorbital bar is resected after a bilateral frontal craniotomy, and have widely applied this surgical technique not merely to benign tumors but also to malignant tumors of the frontal base. In radical surgery involving malignant tumors of the paranasal sinuses that have invaded the frontal base, it is important to perform an en-bloc resection of such tumors and surrounding healthy structures. The authors describe the case histories of 5 patients with a malignant tumor in the skull base. For their surgical treatment, a combination of the extensive transbasal approach and the transfacial approach was used, and the tumor and its surrounding structures, such as the dura and the orbital content, were resected en bloc. The operative results of these cases were relatively good. Since an en-bloc resection that resembles the authors' method has not been found in the Japanese literature, we discuss our technique, provide some representative cases, and comment on the relevant literature.