The transfrontal approach using nasal endoscopy to treat anterior skull base carcinomas.

We used a simple subcranial procedure that employed nasal endoscopy to resect two anterior skull base tumors. The solid geometry of the deep frontal sinus must be known to determine the appropriateness of this technique. Since 1999 two patients underwent this technique and have exhibited no signs of local or distant disease for 36 months and 32 months, respectively. This approach minimizes visible scarring, provides a wide exposure of the roof of the anterior ethmoid, and reduces the risks of excessive bleeding and neurogenic complications. The patients recovered rapidly so the treatment was cost-effective and the patients achieved an early return to work. We conclude that the transfrontal approach for anterior skull base tumors can be simple and effective. Further studies of this minimally invasive maneuver for high-risk patients are warranted.