VIII Combined Craniotomy-Rhinotomy for Ethmoid Cancer

Abstract

The indications are presented for combined anterior fossa craniotomy-lateral rhinotomy with en bloc excision of cancers of the frontoethmoid group of sinuses. The procedure is described and 2 relevant cases presented. In 1, a planned, combined procedure was undertaken but, because of the extent of the disease, was not completed. Recurrence of the tumor after initially effective postoperative radiotherapy led to a 2nd and more successful operation which gave 16 mo. of excellent palliation. In the other case, thought to be massive, benign sinonasal polyposis, anterior fossa involvement was discovered at emergency craniotomy after a preliminary 1st stage rhinological procedure which failed to disclose evidence of cancer. Despite massive intracranial involvement by a mesenchymal sarcoma of the ethmoid, a later combined operation was contemplated but not carried out because of death from meningitis attending an uncontrollable cerebrospinal fluid leak.