Preservation of the Olfactory Tract in Bifrontal Craniotomy for Various Lesions of the Anterior Cranial Fossa

Abstract

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. 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. We obtained complete preservation of the olfactory tracts and normal postoperative olfaction in all 12 cases. 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.