PMC3390128_01
(A) Axial and (B) coronal preoperative computed tomography (CT) imaging of the orbits and paranasal sinuses show extensive submucosal destruction of the skull base and lateral nasal wall with no evidence of bone in the right fovea ethmoidalis. (C) Axial and (D) coronal postoperative CT imaging show the acellular dermal allograft in the right fovea ethmoidalis (white arrow) and Merocel nasal tampon supporting the skull base repair site (yellow arrows).
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F1
CT scanning of the orbits and paranasal sinuses showed destruction of the ethmoid air cells and lateral nasal wall with excessive thinning of the anterior skull base and a Keros type I cribriform configuration (Fig. 1, A and B). Postoperative CT scan showed no intracranial pathology (Fig. 1, C and D).
Eighteen months postoperative 4-mm 30  nasal endoscopy shows (A) a well-mucosolized repair site (red circle) of the right anterior skull base defect, with an intact skull base posteriorly (wide white arrow), and widened nasal cavity bilaterally. (A) Right and (B) left images show the superior sinonasal cavity and (C) right and (D) left images depict the inferior nasal cavity. Thin white arrow, uncinate process; thin black arrow, middle turbinate; wide black arrow, nasal septum; thin yellow arrow, inferior turbinates; green arrows, choanal arch.
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F2
Her follow-up examination 18 months after surgery revealed a well-mucosolized defect site with a widened nasal cavity (Fig. 2, A-D).