Anterior and Middle Skull Base Surgery: The SNUH Experience.
- Author:
Chul Hee LEE
1
;
Ha Won JUNG
;
Chae Seo RHEE
;
Hong Ju PARK
;
Jeong Hun HAH
;
Yang Gi MIN
;
Hee Won JUNG
;
Chang Wan OH
Author Information
1. Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Skull base;
Neoplasm;
Trauma;
Malformation;
Crainofacial resection;
Surgery
- MeSH:
Angiofibroma;
Cavernous Sinus;
Encephalocele;
Humans;
Meningioma;
Mortality;
Recurrence;
Skull Base*;
Skull*;
Survival Rate
- From:Korean Journal of Otolaryngology - Head and Neck Surgery
1998;41(2):218-225
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVES: The purpose of this study is to evaluate the effectiveness of skull base surgery on local control and survival of skull base lesions. In addition, the complications and their impact on the tumor control status as well as postoperative morbidity are considered. MATERIALS AND METHODS: We report our experience on 35 patients with skull base lesions. The patients were divided into two subgroups: (1) anterior skull base group (n=27) and (2) middle skull base group (n=8). RESULTS: For the anterior skull base group, the overall survival rate for malignant tumor (n=15) at 16 months was 53% without regard to histologic types. The overall operative mortality rate was 0% and the complication rate was 25% with craniofacial resection for control of neoplasm (n=20) and all of these complications were managed successfully without any sequelae. The technique of craniofacial resection was applied to the management of skull base trauma (n=4) and encephaloceles (n=3) successfully. The middle skull base group consisted of 5 patients with juvenile nasopharyngeal angiofibroma, and one patient each with malignant meningioma, meningioma, fibrous dysplasia, respectively. All JNA patients were managed with a combined intracranial and transmaxillary/transpalatal approach. Among them, 4 patients were cured and one patient developed a recurrence near the cavernous sinus. Surgical morbidity was minimal and there was no mortality. Facial translocation approach to the skull base was utilized in 2 patients. CONCLUSION: Craniofacial resection is a valid surgical technique for surgical management of tumors involving the anterior skull base and also can be applied to the treatment of selected trauma and malformations. The combined intracranial and transmaxillary/transpalatal approach is a safe and reliable method to remove nasopharyngeal angiofibroma with intracranial invasion.
