• Anterior skull base surgery;
  • craniofacial resection;
  • olfaction;
  • smell;
  • subcranial.


Objectives/Hypothesis In selected unilateral tumors and defects of the anterior skull base, the preservation of contralateral olfaction is achievable through a localized subcranial approach without compromising surgical objectives of resection or repair.

Study Design Description of a functional adaptation of anterior skull base surgical techniques through a retrospective patient series.

Methods Nine patients underwent anterior skull base surgery for unilateral cribriform plate disease including four malignant and two benign tumors, two encephaloceles, and one iatrogenic cribriform injury with cerebrospinal rhinorrhea. All nine patients consented to a localized subcranial approach to the anterior skull base to preserve the contralateral olfactory nerves. In four patients with benign disease a portion of the ipsilateral nerves was additionally conserved. Postoperative olfaction was assessed objectively with a commercially available smell test. Indications, technique, results, and complications are reported and discussed.

Results All patients had eradication of disease with preservation of functional olfaction

Conclusions Conservation of olfaction is possible in selected cases of anterior skull base surgery when the lesion is unilaterally confined.