Surgical management and follow-up of lateral skull base tumors: An 8-year review

Abstract

Abstract. The purpose of the present article was to describe the diagnostic evaluation of, and surgical approaches to, lateral skull base tumors (LSBTs). The study is a retrospective review of 21 patients diagnosed with tumors that involve lateral skull base (8 with malignant diseases and 13 with benign lesions) who were surgically treated during a 8-year period. The transparotid-transmandibular (38%) was the most commonly performed surgical procedure, followed by the transmandibular (24%), the transmaxillary (24%), the transcervical approach (10%) and the combined approach (4%). The surgical procedures were uneventful and there were no postoperative mortalities. Complications were encountered in 12 cases, and morbidity was not remarkable during the perioperative stages. After an average follow-up of 46 months, only 1 of 14 patients with benign diseases had a recurrence following the resection of a pleomorphic adenoma. Of 7 patients with malignant tumors, 5 are alive with no evidence of disease. The majority of the benign lateral skull base tumors can be removed surgically with a low rate of complications and recurrence. However, malignant neoplasms carry a poor prognosis and a low rate of disease-free survival.

Clinical application of a three-dimensional-printed model in the treatment of intracranial and extracranial communicating tumors: a pilot study

“…Of all patients, seven had tumor involvement in the middle cranial fossa (including one case with anterior cranial fossa involvement) and one had tumor involvement in the posterior cranial fossa. The higher proportion of patients with tumors in the middle cranial fossa may be partially attributed to the fact that most skull base tumors requiring oral-maxillofacial surgery are located in this region [ 17 ]. Moreover, six out of eight patients had a tumor with the largest diameter being > 5 cm, which corresponds to the insidious growth pattern observed in ventral skull base tumors [ 18 ].…”

“…The common approaches for anterior skull base tumors include unilateral frontal, bilateral frontal, modified orbitozygomatic and pterional approach [ 6 ]. For middle skull base tumors, the transmandibular, transmaxilliary and transcervical approaches are widely used [ 17 ]. However, once the tumor breaks through the skull base into the cranial cavity, surgical management often requires focusing on both the intracranial and extracranial lesions.…”

Audit of Complications in an Otolaryngology Led Skull-Base Surgical Practice

“…The initially developed transtemporal and infratemporal fossa procedures were developed as per this guiding principle. [13][14][15] Wide bony dissection in the skull-base enabled excellent access to the dura and adjoining neurovascular structures with negligible brain retraction. Wide exposure further enabled closer access to the surgical site with shorter and proximally held instruments, thus leading to more precise and tremor free surgical work on the critical skull-base.…”

Treatment of Skull Base Diseases: A Multidisciplinary Challenge

“…Among these histological varieties, there are entities that are characteristic of this site, such as olfactory neuroblastoma and juvenile angiofibroma, which require specific treatment approaches. Tumors of the lateral skull base can either arise primarily from the temporal structures (i.e., the external auditory canal, middle ear, or mastoid) or invade them secondarily [ 3 , 4 ]. Common extratemporal origins include the parotid gland, auricle, and infratemporal fossa (comprising cutaneous, salivary, or mesenchymal histologies), whereas most primary lateral skull base tumors are cutaneous, originating from the skin of the external acoustic canal [ 5 ].…”