Surgical management of anterior skull-base malignancies (endoscopic vs. craniofacial resection)

Albonette-Felicio, Thiago; Rangel, Gustavo; Martínez-Pérez, Rafael; Hardesty, Douglas A.; Carrau, Ricardo L.; Prevedello, Daniel M.

doi:10.1007/s11060-020-03413-y

Cited by 20 publications

(14 citation statements)

References 35 publications

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“…Malignant tumors invading the anterior skull base, midface and sinonasal cavities are extremely rare with an incidence of approximately 0.6 to 0.8 per 100.000 population per year [1,2]. They account for 3-6% of malignancies of the head & neck region [3,4]. The variety of histological subtypes and cell lines, rampant tumor growth and the complex anatomy of the affected structures require a multidisciplinary, highly specialized treatment.…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Dural Reconstruction with or without A Bone Graft Following Oncologic Resections of Paranasal and Anterior Skullbase Malignancies

Konietzko¹,

Bonk²,

Schaller³

et al. 2022

Preprint

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The reconstruction of frontobasal defects following oncologic resections of paranasal and anterior skull base malignancies remains challenging. Ineffective reconstruction could lead to cerebrospinal fluid leak, meningitis, and tension pneumocephalus. Aim of this investigation was to analyse postoperative complication rates with or without bone graft for anterior skull base reconstruction. In this retrospective study, we included patients following resection of paranasal and/or anterior skull base malignancies between October 2013 and November 2020. Complications were analysed with regards to the type of skull base reconstruction. Ten patients were identified (2 female, 8 male, age (median, SD) 65±14.8 years (range 38 – 81). There were eight cases of paranasal sinus and nasal cavity carcinomas and two cases of olfactory neuroblastomas. Overall survival was 20±25.1 months (range: 5-72), progression free survival was 17.0±20.3 months (range: 4-72). Bone skull base reconstruction using a split graft was performed in three cases. Postoperative complications requiring surgical intervention were seen in 33% (one tension pneumocephalus) of cases in the bone reconstruction group and 57% (three patients with cerebrospinal fluid leak, one infection) in the non-bone reconstruction group. Additional bone reconstruction of the anterior skull base seems to lower the CSF leakage rate due to the additional abutment following resection of paranasal and anterior skullbase malignancies.

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Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Dural Reconstruction with or without A Bone Graft Following Oncologic Resections of Paranasal and Anterior Skullbase Malignancies

Konietzko¹,

Bonk²,

Schaller³

et al. 2022

Preprint

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“…Craniofacial resections (CFR) are complex procedures that have evolved in safety and indications since first being described (1). Advances in imaging, surgical technology, and reconstructive techniques have led to re-defined applications and limitations, with wider resections but satisfactory oncologic results (14).…”

Section: ' Discussionmentioning

confidence: 99%

Short-term survival in extensive craniofacial resections

Leite

Alvarenga

Gonçalves

et al. 2021

Clinics

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Craniofacial resection (CFR) procedures for craniofacial tumors with cranial extension are often extensive. Although CFRs may yield good oncological results, there are concerns about high perioperative morbidity and mortality. This study aimed to determine risk factors for perioperative mortality after open CFR in terms of deaths occurring during index hospitalizations. METHODS: We conducted a retrospective analysis of CFRs conducted at a tertiary oncology hospital from May 2009 through December 2018. RESULTS: Our analysis included data from the medical records of 102 patients, the majority of whom were male (n=74, 72.5%). The mean age was 61 years ( ± 18.3 years). Skin malignancies (n=64, 63.4%) accounted for nearly two-thirds of the treated tumors, and most of these were squamous cell carcinoma. Postoperative medical complications occurred in 33 patients (33%), and surgical complications occurred in 48 (47%). Multivariate analysis revealed the only independent risk factors for perioperative deaths to be the presence of intracranial tumor extension on preoperative imaging (hazard ratio [HR]=4.56; 95% confidence interval [CI]: 1.74-11.97; p=0.002) and the unexpected emergence of postoperative neurological dysfunction (HR=10.9; 95% CI: 2.21-54.3; p=0.003). CONCLUSIONS: In our study, factors related to tumor extension were associated with a higher risk of perioperative death.

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“…However, the craniofacial approach requires a large facial skin incision, which may lead to morbidities such as osteomyelitis, wound infection, facial anesthesia, and diplopia, and postoperative cosmetic results are not satisfactory and involve a longer recovery time. 10) The endoscopic endonasal approach, which can help overcome these problems, was initially limited to benign disease in the nasal cavity and has been developed and started to be adopted for malignant tumors that extend into the anterior skull base with piecemeal resection as first reported by Yuen et al in 1997. 11) This method has been criticized because it ignores the common principal that malignant tumors should be resected en bloc.…”

Section: Discussionmentioning

confidence: 99%

“… 8 , 9) However, some recent reports showed that less invasive methods with endoscopic endonasal tumor removal result in the same tumor control rate as conventional craniofacial resection with better cosmetic results. 10 , 12) To select the appropriate approach in each case, Naunheim et al proposed an algorithm of approaches for malignant tumors in the anterior skull base. He suggested the following four approaches depending on the tumor location and extent: endoscopic, endoscopic and craniotomy, transfacial, and transfacial and craniotomy.…”

Section: Discussionmentioning

confidence: 99%

Large Cell Neuroendocrine Carcinoma in the Sinonasal Cavity with Large Intracranial Extension Treated with Endonasal Endoscopic and Transcranial Combined Surgery: A Case Report

Rai

Nishioka

Hara

2021

NMC Case Report Journal

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Large cell neuroendocrine carcinoma (LCNEC) is a rare malignant tumor that typically arises in the lungs. It is especially rare in the sinonasal cavity, and treatment has not been established. In this study, we present the case of a 56-year-old woman with a large sinonasal LCNEC that extended into her brain. We performed endonasal endoscopic and transcranial combined surgery followed by chemoradiation therapy. The combined surgery enabled us to approach and remove the extensive tumor from two different directions at one time less invasively. We have achieved good tumor control for 18 months so far.

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Surgical management of anterior skull-base malignancies (endoscopic vs. craniofacial resection)

Cited by 20 publications

References 35 publications

WITHDRAWN: Dural Reconstruction with or without A Bone Graft Following Oncologic Resections of Paranasal and Anterior Skullbase Malignancies

WITHDRAWN: Dural Reconstruction with or without A Bone Graft Following Oncologic Resections of Paranasal and Anterior Skullbase Malignancies

Short-term survival in extensive craniofacial resections

Large Cell Neuroendocrine Carcinoma in the Sinonasal Cavity with Large Intracranial Extension Treated with Endonasal Endoscopic and Transcranial Combined Surgery: A Case Report

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