Craniofacial Resection of Anterior Skull Base Tumours: Factors Contributing to Success

Abstract

Background:A case series of 20 consecutive patients followed for a minimum of 54 months following craniofacial resection of anterior skull base tumours is presented, with the aim of identifying complications and factors influencing survival. Methods: A retrospective review of a case series of 20 consecutive patients was carried out. Results: Dural invasion was significantly correlated with poorer survival. There was also a tendency for tumour grade and positive resection margins to be associated with poorer outcome. Most local recurrences occurred within 6 months of surgery, with the exception of adenocarcinoma of the ethmoids, in which recurrence occurred up to 36 months postoperatively. A variety of complications were encountered, with a marked decrease in serious complications from midway through the series. Conclusions:The change in pattern of complications may be indicative of a learning curve, or the discontinuation of the use of lumbar drainage.

Feasibility of Combined Operation and Perioperative Intensity-Modulated Brachytherapy of Advanced/Recurrent Malignancies Involving the Skull Base

“…The incidence of surgery-related complications in our series was comparable to other studies [12,28,34]. Fukuda et al [12] observed postoperative complications in 62 out of 143 cases of their large, multiinstitutional study on surgical results of skull base surgery for the treatment of head and neck malignancies involving the base of the skull.…”

“…It deserves to be noted that operation-related complications of our series occurred nearly exclusively in cases with extensive intradural tumor extension and subsequent surgical reconstruction of the dura. Rutter et al [34] reported a variety of complications and a change in the complication pattern during the course of their series indicating a learning curve. Likewise, after optimizing the operative technique, infections as well as CSF leakages were successfully prevented in our five most recent cases.…”

Role of Perioperative Brachytherapy in the Treatment of Malignancies Involving the Skull Base and Orbit

“…5 Seven of the 8 patients showed infiltration of at least 1 orbit and 5 patients infiltration of dura. Conclusively, the craniofacial approach, which is quite common standard, 84,85 was performed in most patients. A purely transfacial approach (lateral rhinotomy) was selected in the other cases if tumor extended to the anterior nasal cavity or laterally beyond the medial third of the maxillary sinus.…”

Diagnostik, Therapie und Ergebnisse in der Behandlung maligner Schädelbasistumoren1

“…Da im Allgemeinen das Risiko für die Entwicklung eines Rezidives in den ersten 6 Monaten am gröûten ist, sollte zunächst alle 3 Monate, nach 2 Jahren alle 6 Monate eine klinische Kontrolluntersuchung erfolgen. Eine Ausnahme stellen Adenokarzinome dar, bei denen auch noch nach 36 Monaten Rezidive beschrieben wurden[21]. In Übereinstimmung mit Draf empfehlen wir zusätzlich eine radiologische Kontrolle[14].…”