الفهرس 
Abstract
AnatomyOnly 14 pages are availabe for public view
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Abstract
Anterior skull base lesions represent a special challenge to surgeons due to the complex anatomy of the area. While small lesions are easy to remove, large lesions can pose complex situations. The most difficult aspects are not only the approach and removal, but specially the repair of the defects created by the resection of the lesion. (Vanaclocha, et al 1997)
Anatomically, anterior skull base is bound anteriorly by the frontal bone, inferiorly by the orbital roofs. The foramen cecum is in the midline behind the frontal bone, its posterior and lateral boundaries formed by the ethmoid bone. The crista galli is an osseous ridge arising from the midline of the ethmoid bone. The cribriform plate which is on either side of the crista contains the olfactory foramina through which the anterior and posterior ethmoidal arteries and olfactory nerves travel. The planum sphenoidale and the lesser wing of the sphenoid constitute the posterior floor of the anterior skull base behind the cribriform plate. The blood supply to the anterior skull base is from ICA via the anterior and posterior ethmoidal arteries and ECA via middle meningeal artery. (Ketan, et al 2002)
In the area of the skull base, a bony plate separates the intracranial compartment from the extra cranial compartment, and pathologies may arise in this bony separation or in the intracranial compartment or extra cranial compartment, so evaluation with both CT and MRI maybe needed to approach these pathologies. (Rakesh, et al 2014)
Anterior skull base lesions may be congenital lesions as dermoid cysts, encephalocele and meningocele. Bacterial infections as subdural or epidural empyema, intraparenchymal abscess, cerebritis and meningitis, fungal infection as mucormycosis. Tumors as olfactory groove meningiomas, subfrontal meningiomas, tuberculum sellae meningiomas and chondrosarcoma.
(SF Morales et al,2014)
Because of increased emphasis on smaller craniotomies tailored to specific pathology, the supraorbital craniotomy has evolved as a result of stepwise modifications to standard subfrontal approach which involve generous skin and bone flaps. The supraorbital craniotomy is a “keyhole craniotomy” with important strengths and limitations.