Craniofacial resection via frontal craniotomy

Treatment of diseases: nasal glioma meningioma Indication Almost all tumors involving the anterior cranial fossa can be removed through the craniofacial route. 1. Benign tumors of the meninges and anterior skull base, such as meningioma, bone fiber lesions, tumors from bone or cartilage. 2. Scarnal lesions and orbital tumors, such as adenoid cystic carcinoma of the lacrimal gland. 3. Nasal tumors, such as nasal gliomas, nasal septal chondromas, cancer, and mucosal melanoma. 4. Upper group of paranasal sinus tumors. 5. Amplify or involve the dura mater and benign malignant tumors. Contraindications 1. Tumors that extend to the nasopharynx, cavernous sinus, or mid-cranial fossa sometimes require several surgical approaches, even in conjunction with various surgical exposures that do not include areas of tumor expansion. 2. Undifferentiated carcinomas or adenoid cystic carcinomas that involve the brain or optic chiasm, or have metastasized to the cervical lymph nodes and have usually metastasized throughout the body, due to their biological behavior, are rarely worthy of surgical resection. Patients who have been transferred to the body have been identified, and no craniofacial resection is considered. Preoperative preparation 1. Bacterial culture and drug susceptibility test of nasal cavity or tumor bed 24 to 48 hours before operation. 2. Intravenous antibiotic prophylaxis was started within 6 hours before surgery. 3. You can shave the hair on the front scalp; you can also shave your head with soap, rinse with alcohol, and bundle the hair along the coronal incision line. It will not cause infection after unshaved. 4. Lumbar subarachnoid cerebrospinal fluid drainage. Surgical procedure Coronal incision Conventional incision and hemostasis. 2. Flap If the forehead sinus or iliac bone flap is used for bone shaping, the flap is turned up in the lower plane of the aponeurotic aponeurosis. Otherwise, the skull membrane can be turned up with the aponeurosis. Carefully protect the blood vessels from the jaws. 3. Remove the frontal sinus front plate The edge of the frontal sinus is marked according to the X-ray film, the edge is cut with a oscillating saw, the front plate is removed, the bone forming flap is pulled open and the frontal sinus mucosa is scraped off. 4. Reveal the dura mater Use a cutting drill to grind the posterior plate of the frontal sinus on both sides of the thin midline until it can be removed from the dura mater. Then lift the dura mater and remove the posterior plate of the frontal bone with a rongeur. 5. Isolation of the dura mater The dura mater is separated on both sides of the cockscomb. Use a needle-nose rongeur to remove the cockscomb. The olfactory nerve was cut with a scalpel and the dura mater was separated until the posterolateral optic nerve was visible. The sphenoid plane is not revealed. The extent of lateral separation depends on the extent of the resection. 6. Repair dura mater Bipolar coagulator stops bleeding. The dural tear is sutured, such as easy to pull, or covered with 3% hydrogen peroxide pad for suturing or transplanting through the facial route. complication 1. Cerebral cortical infarction. 2. Duratorial and subdural hematoma. 3. Cerebrospinal fluid rhinorrhea. 4. Infection. 5. Radioactive osteonecrosis.