Radical surgery for ethmoid cancer.

Radical surgery followed by radiotherapy offers the best chance of cure for ethmoid cancer. In operations on 15 patients with ethmoid cancer, intracranial spread was found in five instances. In every patient, a craniofacial ethmoidectomy was performed. Two approaches are recommended. If there is radiologic or clinical evidence of intracranial spread, a frontal craniotomy and lateral rhinotomy approach is employed. With the help of the neurosurgeon, the overlying dura can be resected with the anterior cranial floor. When the cribriform plate appears intact, the resection is accomplished via a lateral rhinotomy and transfrontal sinus approach to the anterior cranial fossa. These techniques were used in 15 patients. Nine are free of recurrence after an observation time of two to seven years.