En block resection of a malignant tumor of the nasal cavity that was invading the orbit and anterior cranial base: A case report

Abstract

We report a case of malignant tumor of nasal cavity that was invading the orbit and anterior cranial base treated by craniofacial resection. The cranial procedure was performed by reflection of dismasking facial skin flap and a facial approach for the maxillectomy performed by a sublabial superior gingival incision were combined. En block excision with a safety margin was successfully achieved due to the wide exposure of the tumor made possible with this procedure. The en block specimen included bilateral cribliform plates, the ipsilateral orbit and its contents, the upper side of the sphenoid body and maxilla, and the nasal septum. After the resection, the anterior cranial base was reconstructed using a titanium mesh plate, and the orbito-facial reconstruction was accomplished using a free abdominal fatty graft. The patient's cosmetic results were acceptable due to the orbital reconstruction and the preservation of facial nerve function.