Employment of anterior craniofacial resection by intracranial extension ossifying fibromas originating from the ethmoid sinuses
1st Azerbaijan Oral and Maxillofacial Surgeons (AzOMFS) Congress (Baku, 14-16/03, 2019).
Ossifying fibromas (OF) of the ethmoid sinuses (ES), treat benign bone tumors, and up to morphological structure consists of a fibrous stroma.
Difficulties of the oncotomy by an endoscopic method which received popularity now are connected with danger of damaging to the orbital structures and the dura mater to the anterior cranial fossa (ACF) region. At the same time, leaving part of the tumor on the orbital medial wall and/or an ethmoid labyrinth roof [to the "lamina cribrosa" (LC) region] at that is fraught with a recurrent tumor which frequency changes from 30 to 58% (Slootweg P.J. et al., 1994).
Efficiency of anterior craniofacial resection (ACFR) applied at some tumors of the skull base (Rzaev R. M. et al., 2015), allows to hope for the most successful treatment of patients with widespread OF ES.
Research objectives – the analysis of results and efficiency assessment ACFR during removal of intracranial extension OF originating from the ES
Patients and methods. Under observation there were 3 patients with histology the verified OF, basic bulk which occupied the ethmoidal labyrinths, both nasal cavities and deformed medial wall of the maxillary sinuses. Carried out by all patients the standard methods of inspection accepted in skull base surgery.
Results. In one patient at the same time, the tumor destruction of medial wall and penetrated into the left maxillary sinus and deformed of both medial orbital walls, extended in posterior ethmoid cells and destruction of LC. The other two patients, the tumor also extended in sphenoid sinuses, destruction LC and penetrated into the ACF.
Conclusion. By all patients has been made ACFR, which has provided radical removal of the tumor. Primary plasty floor defect of the ACF, along with expected treatment is carrying out, allowed eliminate cerebrospinal fluid rhinorrhea, arising in the early postoperative period, and provided stable hermetic sealing of defect in the remote postoperative period.