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

OBJECTIVE: 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. METHODS: 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. RESULTS: We obtained complete preservation of the olfactory tracts and normal postoperative olfaction in all 12 cases. CONCLUSION: 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.