Anterior Skull Base Resection: External Approaches

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2025-03-04

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Open Access Atlas of Otolaryngology, Head & Neck Operative Surgery

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University of Cape Town

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Abstract
The sinonasal cavity and anterior cranial fossa can be involved by a wide variety of diverse, rare neoplasms. Surgical extirpation of these lesions is often the mainstay of multimodal treatment for both benign and malignant diseases. However, these tumours pose a variety of challenges for surgical management, including complex anatomic considerations. The nasal cavity can be imagined as a quadrangular corridor that is narrower at the top and divided into right and left compartments by a midline septum. It communicates with the exterior through anterior openings, the nares (nostrils). Posteriorly, it opens into the nasopharynx through the posterior choanae. Its external shape reflects its skeletal support, which is composed of the paired nasal bones and the upper and lower lateral nasal cartilages as they surround the pyriform aperture. The walls of each nasal fossa include the nasal septum medially, the horizontal portion of the maxillary bone and palatine bone inferiorly, and the inferior turbinates and ethmoid bones laterally.
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