The surgical management of osseous cranial base tumours in children.
BACKGROUND
Osseous cranial base tumours in children present as a diverse collection of both benign and malignant pathologies. Concerns raised by the difficulty in accurate diagnosis and local recurrence of benign lesions and by the long-term sequelae of radiotherapy for malignant cranial tumours (marked local growth disturbances, pituitary dysfunction, visual disturbances, late new tumour induction) prompted an evaluation of surgical resection of cranial base tumours in children, with specific regard to safety, efficacy and aesthetic result.


METHODS
A retrospective review was performed of 10 consecutive children presenting with tumours either arising from or eroding into bone of the cranial base who were managed by surgical resection in a 10-year period from 1986 to 1996. The patients demonstrated a great variation in both presentation and pathology. All underwent surgical resection of tumour with reconstruction where indicated.


RESULTS
There were no postoperative complications or mortality. All patients remained clinically free of disease at follow-up, which ranged from 17 months to 9 years (mean 6 years and 4 months).


CONCLUSIONS
The aggressive surgical resection and craniofacial reconstruction of cranial base tumours in the paediatric population offers a safe and efficacious mode of treatment that obviates problems of diagnosis and local recurrence for benign lesions and of the long-term sequelae of radiotherapy for malignant lesions.
Holmes
A D
AD
Melbourne Craniofacial Unit, Royal Children's Hospital, Victoria, Australia.
Klug
G L
GL
Breidahl
A F
AF
D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005145:Face / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000601:surgery*; D012886:Skull / Q000601:surgery; D019292:Skull Base Neoplasms / Q000188:drug therapy / Q000601:surgery*
D000970:Antineoplastic Agents