Abstract

Resection of paranasal sinus tumor often presents difficult technical problems when it invades cranial base. In this paper, we discuss the possibility of complete en bloc resection of paranasal sinus carcinomas extending to the cranial base by comparing operative findings with such imagings as CT, MRI, 3-DCT and microangiography. Clinicoradiographic findings about resectablity of the craniomaxillofacial units involved by paranasal sinus carcinomas reveal that complete en bloc resection is possible with the combined extracranial and extra-or intradural approach except in cases of 1) extensive infiltrations to the anterior and middle cranial base, 2) invasions to the sphenoid body and/or ICA and into the cavernous sinus, and 3) invasions into the brain. Three dimensional CT contributes significantly to make pre and post operative evaluations about resectability of the cranial base. A free rectus abdominis musculocutaneous flap is very useful for the reconstruction of the cranial base and a large maxillofacial defect.