Complications and Outcome of Craniofacial Resection for Anterior Skull Base Tumors

Lee, Sang Hyung; Lee, Dong Yeob; Yang, Hee Jin; Oh, Chang Wan; Jinn, Tae Hoon; Chung, Young Seob; Jung, Hee Won; Cho, Byung Kyu

Abstract

The purpose of this study is to evaluate the complications of anterior craniofacial resection for the neoplasms of invading the anterior cranial base and the effectiveness of anterior craniofacial resection on local control and survival. We analyzed clinical experience of 19 patients with anterior skull base lesions retrospectively, who underwent anterior craniofacial resection between January 1991 and November 1997 at the Department of Neurosurgery joining with Otolaryngology. Seventeen cases were malignant tumor. The spectrum of disease included esthesioneurobla- stoma(7 patients), squamous cell carcinoma(4 patients), malignant teratoma(2 patients), and others were malignant melanoma, undifferented cell carcinoma, osteogenic sarcoma, Ewing's sarcoma. Two patients had ossifying fibroma. There was no operative mortality. The complications occurred in 11 cases(58%). Patients with complications included six cases of infection, two with CSF leak. Others were transient impairment of mental status pneumoce-phalus and transient diplopia. In six cases with infection, two case of osteomyelitis were managed by surgical removal of infected bone flap, the others were controlled conservatively without any sequelae. The overall survival rate for malignant tumor at 14 months is 53%. There was a t rend to decreased survival time in regard of tumor invasion to the bone, the dura, and the parenchyme. Presence of orbital invasion showed significant influence on survival tirne. Anterior craniofacial resection is a relatively safe procedure for surgical management of tumors involving the anterior skull base with o r without intracranial invasion.