Reconstruction purposes to attain a watertight seal between the intracranial space and the upper respiratory system thus preventing CSF leak, brain herniation and meningitis. Advances in surgical technique and reconstruction have made larger and more complex lesions amenable to surgical resection. Close and constant cooperation between the neurosurgeon, otolaryngologist, and pathologist is absolutely necessary to the benefit of the patient. The decision for type of approach depends on the training of the surgeon, available resources, and tumor histology and structures involved. This is a retrospective study that was performed at the otorhinolaryngology departement, Kasr El-Aini Hospital, Cairo University during the period from October 2007 to December 2011. It included 12 patients whom presented to the outpatient clinic with a clinical diagnosis of sinonasal mass extending to anterior skull base. They were distributed and subdivided into two groups; Group (A) included 6 patients who were subjected to TCFR. Group (B) included 6 patients who had ECFR. The most common malignant histopathological types were olfactory neuroblastoma. Angiofibroma was the most common benign tumor.