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The Transglabellar/Subcranial Approach to the Anterior Skull Base
A Review of 72 Cases
Robert M. Kellman, MD;
Lawrence Marentette, MD
Arch Otolaryngol Head Neck Surg. 2001;127:687-690.
Objectives To describe the transglabellar/subcranial approach to the anterior skull
base and to compare it with more traditional approaches to craniofacial resection.
Design A retrospective analysis of 72 cases at 2 academic medical centers.
The main parameters analyzed were the disease entities treated, the average
operating room time, the average amount of blood loss, the number of transfusions,
the length of intensive care unit and hospital stays, and complication rates.
These were compared with published data for traditional craniofacial approaches.
Setting All patients were operated on by the authors in collaboration with neurosurgical
teams at the State University of New York Upstate Medical University, Syracuse,
and the University of Michigan Hospital, Ann Arbor.
Patients The transglabellar/subcranial approach was performed 72 times in 69
patients in this series. Forty-two procedures in 40 patients were performed
for malignant disease and 30 procedures in 29 patients were performed for
benign entities. Patients' ages ranged from 2 to 78 years. Follow-up ranged
from 6 months to 4 years, with a minimum follow-up of 1 year for survivors.
Results There were no operative mortalities. Operating time, average amount
of blood loss, length of hospital and intensive care unit stays, and complication
rates compared favorably with published results of traditional craniofacial
resections.
Conclusions The transglabellar/subcranial approach to the anterior skull base may
be a reasonable technique for the surgical management of lesions in the region
of the anterior skull base. It provides excellent exposure of the nasal cavity,
the orbits, and the ethmoid and sphenoid sinuses, while allowing wide access
to the anterior fossa with a minimum amount of frontal lobe retraction.
From the Departments of Otolaryngology, State University of New York
Upstate Medical University, Syracuse (Dr Kellman), and University of Michigan,
Ann Arbor (Dr Marentette).
Corresponding author and reprints: Robert MKellman, MD, Department
of Otolaryngology, Upstate Medical University, 750 E Adams St, Syracuse, NY
13210.
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