Circulatory changes caused by a closed, negative pressure drainage system after craniotomy.
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OBJECTIVE: Preservation of the olfactory tract during use of the bifrontal approach for the treatment of lesions located in the frontal cranial base and the supra- and parasellar regions has not been previously investigated. METHODS: In our study, 12 patients underwent surgery, via the basal subfrontal route, for treatment of various lesions. All patients were observed prospectively, and olfactometry was performed pre- and postoperatively by an independent otorhinolaryngologist. RESULTS: We obtained complete preservation of the olfactory tracts and normal postoperative olfaction in all 12 cases. CONCLUSION: The bifrontal approach yields a bilateral wide operative field with excellent orientation and views of important structures. The shortcomings of this method, i.e., damage to the olfactory tracts and postoperative anosmia, can be overcome.
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This study brings to light the potential use of intracranial endoscopic techniques that can be combined with osteotomies and bone distraction to improve precision and reduce complications in craniofacial surgery. It also anticipates the widespread use of endoscopic techniques to reduce the morbidity and mortality of plastic surgical and neurosurgical intracranial surgery.