Craniofacial resection for large tumors of the paranasal sinuses.

Large tumors of the paranasal sinuses can be removed thoroughly with a craniofacial approach that provides for good visualization. With this approach, some tumors previously considered inoperable may be removed and in some cases cured. We report three cases of tumors managed by means of a craniofacial procedure. One case involved an extensive inverting papilloma of the ethmoid sinus that invaded the orbit and coursed over the globe around the optic nerve. The second patient had a large squamous cell carcinoma of the paranasal sinuses that involved the cribriform plate, dura, and a portion of frontal lobe. The third case involved a meningioma that invaded the sphenoid wing, orbit, pterygomaxillary space, and infratemporal fossa. The craniofacial surgical technique and adjunctive therapies are discussed.