The extent of excision of the skull base was marked with a diamond burr. In one patient the frontal lobe was removed. The posterior extent was upto anterior clinoid process. Osteostomy was performed using fine osteostome till bone was loose to be delivered from below. Facial part of the surgery is then undertaken through Weber-Ferguson incision.
Skin flap is raised, the median maxillectomy is done, to encompass the tumour widely.
The cranial part was released by cutting the soft tissue attachment and the specimen was delivered through the facial approach. At no time pushing or pressure was used. The gap in the anterior cranial fossa was left open since we believe that dura is strong enough to prevent herniation of the brain. In all cases the sphenoid sinus mucosa was scrapped and taken separately for histopathological examination. The skin graft etc was not used.