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A monobloc resection of the fronto-ethmoid sphenoid area may be performed through a combined cranial and facial approach. Osmotic cerebral dehydration increases the exposure of the anterior cranial fossa. The results of treatment in 26 patients (24 with malignant disease of the ethmoid area who had disease recurrence after previous radiotherapy with or without surgery) and the complications encountered are described. The clinical details of 9 of these patients have been included in an earlier report (Clifford 1977).