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Revista Española de Cirugía Oral y Maxilofacial

On-line version ISSN 2173-9161Print version ISSN 1130-0558


ZUBILLAGA RODRIGUEZ, I.; SANCHEZ ANICETO, G.; MONTALVO MORENO, J.J.  and  DIAZ LOBATO, R.. Anterior subcranial approach: Discussion and historical review of the surgical technique. Rev Esp Cirug Oral y Maxilofac [online]. 2009, vol.31, n.1, pp.7-16. ISSN 2173-9161.

Introduction. Skull base surgery is now a reality that has become consolidated over the last decades. The dizzyingly rapid technological advances that have taken place have served as a motor for the development of surgical techniques to approach this anatomic region. The foundation for the definitive push forward of this technique was multidisciplinary teamwork. Material and methods. The subcranial approach is described as an alternative to traditional approaches to the skull base. The history of different key steps in the subcranial approach is described and discussed. Discussion. The selection of the most suitable approach to the skull base in each case is essential for obtaining satisfactory surgical results overall. Initially, the selection of an approach depends on the exact anatomic location of the lesion in the skull base, its threedimensional extension, as well as the nature of the lesion. The subcranial approach is an important step in the development of surgical techniques for the skull base. Conclusions. The anterior subcranial approach provides ample and optimal exposure of all the planes of the anterior cranial fossa, from the anterior ethmoidal roof to the clivus-sphenoid plate, including the orbital roofs. This objective is achieved without having to retract the frontal lobes, thus avoiding the associated morbidity and mortality that this maneuver entails. The anterior subcranial approach makes precise earlier management of oncologic pathology with intradural and extradural involvement possible, as well as the treatment of fractures produced by high-energy impact with involvement of the anterior cranial fossa.

Keywords : Subcranial approach; Anterior cranial fossa.

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