400 Gramme on Skull Base and Face: Complete Removal and Reconstruction

Abstract

<i>Background</i>: Huge craniofacial tumors represent a surgical challenge not only for high risk of intraoperative damage of the brain and sense organs of the face, but also for esthetical issues which may occur postoperatively. This surgery is riskier when these processes are represented by massive compact bone such as osteomas. <i>Case presentation</i>: A young patient with huge disfiguring osteoma of anterior skull base extended to sphenoidal, frontal, maxillary sinuses as well as in orbits benefit for a complete removal with craniofacial reconstruction through a surgical teamwork including neurosurgeon, maxillofacial surgeon and ophthalmologist; with an overt satisfactory cosmetic result. Preoperative planning is reported as well as the intraoperative procedure and the postoperative reconstruction and follow up. <i>Conclusion</i>: Craniofacial osteoma represents a surgical and cometic challenge for their resection. This resection is tailored through sophisticated devices such as preoperative 3D (3 dimension) printed model, intraoperative neuronavigation, and the use on custom-made bone. In place where this reported patient is managed, these tools are unavailable. Thus, priority should be given to teamwork with accurate preoperative planning and manually confectioned cranioplasty. Endoscopic approach for these processes gained more and more indication in the resection of these craniofacial and skull base osteomas. Since this device require a learning curve, laboratory training for is proper using as well as in microneurosurgery techniques is highly recommended. A hope is encountered though the humanitarian implication of some organization and universities.