RSS-Feed abonnieren
DOI: 10.1055/s-0028-1096201
© Thieme Medical Publishers
Complications of Skull Base Surgery: An Analysis of 30 Cases
Publikationsverlauf
Publikationsdatum:
29. Oktober 2008 (online)
ABSTRACT
Objectives: To evaluate the risk factors for perioperative complications among patients undergoing craniofacial resection for the treatment of skull base tumors. Design: Retrospective analysis. Participants: The study group comprised 29 patients with skull base tumors (22 malignant and 7 benign) who underwent 30 craniofacial resections at Hokkaido University Hospital between 1989 and 2006. Of these cases, 21 had undergone prior treatment by radiation (16 cases), surgery (7 cases), or chemotherapy (1 case). Moreover, 19 needed extended resection involving the dura (11 cases), brain (5 cases), orbit (12 cases), hard palate (5 cases), skin (3 cases), or cavernous sinus (2 cases). Main outcome measures: Perioperative complications and risk factor associated with their incidence. Results: Perioperative complications occurred in 12 patients (40%; 13 cases). There was a significant difference between complication rates for cases with and without prior therapy (52.4% vs. 11.1%). The complication rate for dural resection cases was 81.8%. There was a significant difference between complication rates for cases with and without dura resection. No postoperative mortality was reported. Conclusions: Craniofacial resection is a safe and effective treatment for skull base tumors. However, additional care is required in patients with extended resection (especially dural) and those who have undergone prior therapy.
KEYWORDS
Complications - craniofacial resection - skull base surgery
REFERENCES
- 1 Ketcham A S, Wilkins R H, VanBuren J M et al.. A combined intracranial transfacial approach to the paranasal sinuses. Am J Surg. 1963; 106 698-703
- 2 Kaplan M H, Feinstein A R. The importance of classifying initial comorbidity in evaluating the outcome of diabetes mellitus. J Chronic Dis. 1974; 27 387-404
- 3 Piccirillo J F. Importance of comorbidity in head and neck cancer. Laryngoscope. 2000; 110 593-602
- 4 Bentz B G, Bilsky M H, Shah J P, Kraus D. Anterior skull base surgery for malignant tumors: a multivariate analysis of 27 years of experience. Head Neck. 2003; 25 515-520
- 5 Kraus D H, Shah J P, Arbit E, Galicich J H, Strong E W. Complications of craniofacial resection for tumors involving the anterior skull base. Head Neck. 1994; 16 307-312
- 6 Patel S G, Singh B, Polluri A et al.. Craniofacial surgery for malignant skull base tumors: report of an international collaborative study. Cancer. 2003; 98 1179-1187
- 7 Shah J P, Kraus D H, Bilsky M H, Gutin P H, Harrison L H, Strong E W. Craniofacial resection for malignant tumors involving the anterior skull base. Arch Otolaryngol Head Neck Surg. 1997; 123 1312-1317
- 8 Dias F L, Sá G M, Kligerman J et al.. Complications of anterior craniofacial resection. Head Neck. 1999; 21 12-20
- 9 Ganly I, Patel S G, Singh B et al.. Complications of craniofacial resection for malignant tumors of the skull base: report of an International Collaborative Study. Head Neck. 2005; 27 445-451
- 10 Clayman G L, DeMonte F, Jaffe D M et al.. Outcome and complications of extended cranial-base resection requiring microvascular free-tissue transfer. Arch Otolaryngol Head Neck Surg. 1995; 121 1253-1257
- 11 Deschler D G, Gutin P H, Mamelak A N, McDermott M W, Kaplan M J. Complications of anterior skull base surgery. Skull Base Surg. 1996; 6 113-118
- 12 Nibu K, Sasaki T, Kawahara N, Sugasawa M, Nakatsuka T, Yamada A. Compications of craniofacial surgery for tumors involving the anterior cranial base. Neurosurgery. 1998; 42 455-461
Tomohiro SakashitaM.D.
Department of Otolaryngology– Head and Neck Surgery, Hokkaido University Graduate School of Medicine
Kita 15, Nishi 7, Kita-ku, Sapporo 060-8638, Japan
eMail: t-sakashita@rosenet.jp