Transglabellar Butterfly Incision for Anterior Cranial Vault Access: Case Report

Abstract

(1) Background: The transglabellar approach, a type of transfacial technique, typically involves glabellar resection and opening the frontal sinus via a bicoronal incision, providing access to the anterior cranial vault. To prevent complications, the frontal sinus is typically obliterated. However, the success of transnasal endoscopic techniques has prompted a re-evaluation of these traditional methods. (2) Methods: This paper provides a brief literature review and discusses the removal of an elongated glioma of the left gyrus rectus (4.4 × 1.9 × 2.2 cm) in a 63-year-old male using a transglabellar subfrontal approach via a butterfly incision, with frontal sinus preservation. (3) Results: An uneventful gross-total resection of a WHO grade II oligodendroglioma was achieved. There is a paucity of literature describing a transglabellar subfrontal approach via a butterfly incision with frontal sinus preservation. (4) Conclusions: The described approach could be utilized in selected cases such as small intra-axial lesions oriented longitudinally along the inferomedial frontal lobe from the posterior wall of the frontal sinus to the anterior communicating artery complex in patients with pre-existing glabellar rhytids. Since this is merely a case presentation, we cannot conclude that this represents established clinical practice. The outcomes of this approach should be investigated in the future.