Abstract
Between 1990 and 1998, 63 patients (39 men and 24 women) underwent a transfacial approach. Based on the level I through level VI classification scheme developed by the Barrow Neurological Institute Skull Base Team, 83 transfacial procedures were performed: 49 procedures involved a single level, 8 involved a level III approach combined with a level V approach, and 3 involved a level I through III aoproach combined with either a pterional craniotomy or orbitozygomatic craniotomy. Eleven procedures were performed in a staged fashion. Thirty-five different pathologies were addressed: Chordomas (7), angiofibromas (7), and pituitary macroadenomas (5) were most common. One patient (1.6%) died postoperatively. Overall, 29 (46%) patients experienced complications after transfacial surgery. Six (9.5%) patients experienced major complications, and 23 (36.5%) patients experienced minor complications. The transfacial surgeries were without complications in 34 (54%) patients. This large series demonstrates the versatility of transfacial skull base approaches for treating benign and malignant lesions. The procedures are associated with good patient outcomes and an acceptable rate of complications.