In patients with intracranial tumor extension, reconstruction of the defect in the anterior cranial fossa floor following surgical resection presents a challenge in providing a durable seal between the nasal and cranial compartments.
We present a new case of nasoseptal chondrosarcoma with anterior cranial fossa extension in a 23-year-old man in whom a durable repair of the osseous defect was successfully implemented with a technique not well known in the otolaryngology literature and not previously associated with the repair of defects caused by these tumors.
Because the SCC in our patient extended into the right orbital apex, the anterior cranial fossa
, the brain, and the sphenoid sinus, it was staged as a T4b lesion.
6,9) They primarily involve the maxillary and ethmoid sinuses, and they extend locally to involve the orbit, cheek, and anterior cranial fossa
T1-weighted, contrast-enhanced magnetic resonance imaging (MRI) found no destructive invasion of the periorbital tissue or of the dura in the anterior cranial fossa
High-resolution CT and magnetic resonance imaging can be used as complementary investigations to precisely delineate the extent of the tumor and to define the involvement of the cribriform plate, anterior cranial fossa, and retromaxillary space.
Billet et al recommended craniofacial resection of all tumors, regardless of whether they invade the anterior cranial fossa or are confined to the nasal roof.
In cases where the lesion breaches the cranial vault, the extent of involvement usually remains extramural and is limited to the anterior cranial fossa
Intracranial extension into the right anterior cranial fossa
was also evident.
Finally, there was evidence of intracranial but extra-axial extension into the anterior cranial fossa
, which had damaged the frontal sinus.