Effects of the subcranial approach on facial growth and development.

OBJECTIVE To analyze the long-term effects of subcranial surgery for anterior skull base tumors on facial growth. STUDY DESIGN AND SETTING Retrospective study (1994 to 2004) in a university-affiliated hospital. Of 108 patients who underwent a subcranial surgical approach for anterior skull base tumors, six adolescents and five young adults fulfilled study entry criteria for age and follow-up data availability (mean, 3.2 +/- 2 years). Cephalometric x-ray films monitored postoperative facial growth. Anteriorly and posteriorly measured horizontal and vertical maxillary growth were compared with normal values. RESULTS All subjects had superiorly positioned maxillae (shorter in patients with long-standing pathologies). The upper incisor teeth were proclined relative to the cranial base reference planes. All cephalometric changes were within a 10 percent deviation of normal values. CONCLUSIONS Subcranial surgery for these tumors minimally affects vertical facial skeleton growth. Early surgery is essential for unaffected horizontal growth. SIGNIFICANCE Guidelines for anterior skull base tumor surgery in adolescents and young adults.