Combined endonasal, endo-orbital and transcranial craniofacial resection of invasive anterior skullbase sinonasal carcinoma: 2D endoscopic video.

Background: Sinonasal malignancies, in which squamous cell carcinomas are the most common are rare and difficult to treat given the location and anatomical structures involved. Sinonasal malignancies often present late due to non-specific and benign symptoms. Partial resections are often associated with poorer outcomes [1]. Combined approaches can improve extent of resection of tumour involving sinonasal tumours with significant intracranial extension and allows skull base reconstructions from above with pericranium and below with a nasal septal flap [2]. Complete resection has been shown to improve metastatic burden and improve survival [3]. Up to 85 % local control with mean follow up of 37 months have been shown with patient's undergoing either endoscopic or combined endoscopic with open cranial resection techniques [4].

Case Description: We present a case a sinonasal carcinoma crossing multiple compartments requiring a multidisciplinary approach for safe, expeditious and total resection via a combined endoscopic and open approach.

Conclusion: Endoscopic Assisted Craniofacial resection can be adjuncted with endo-orbital techniques establishing the lateral border of the resection whilst protecting the orbital contents as well as facilitating resection margins.