[Selection of operative approaches for rhinosinusal malignant tumor involving in the anterior skull base and exploration for reconstruction].
OBJECTIVE
To investigate operative approaches and techniques of reconstruction for rhinosinusal malignant tumors involving in the anterior skull base.


METHODS
In a retrospective study, clinical data of 22 patients treated surgically in our department from 1988 to 2002 were analysed. Lateral rhinotomy was carried out in 8 patients and ampliative rhinotomy in 4 patients; in 10 patients craniofacial operation was performed. Multiple layer fascia flaps were used to repair lager defect in the anterior skull base.


RESULTS
All tumors were totally resected. In lateral rhinotomy, local locoeled meningitis happened in 1 case, and 4 patients in craniofacial operation. None complication with cerebrospinal fluid leaks, encephalomeningocele and intracranial air. All patients were followed up from 6 months to 11 years after surgery. 7 patients died from intracranial infection or metastasis of tumor. 3-year survival rates was 15/19(78.9%); 5-year survival rates was 13/19(68.4%). The tumor invaded the orbital fascia in 9 patients. Vs 4/9 (44.4%) and 2/9(22.2%) for these 3 and 5-year survival rates.


CONCLUSIONS
Selection of operative approaches depends on the size of defects in the anterior skull base, extent of intracranial invasion and location of rhinosinusal malignant tumors; multiple layer fascia flaps can be used to reconstruct bigger defects of the skull base. It is safe, technically easy, effective procedure and worthy to be recommended.
Jiang
Wen
W
Department of Otolaryngology, Xiangya Hospital, Central South University, Changsha 410008.
Feng
Yong
Y
Sun
Zhengliang
Z
Xiao
Jianyun
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000473:pathology / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000473:pathology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D019291:Skull Base / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000556:secondary / Q000601:surgery*