Surgical strategies in the removal of malignant tumors and benign lesions of the anterior skull base.
The choice of surgical approaches to the tumors of the anterior skull base is determined by the location, dimensions of such lesions and their relations to the surrounding structures. Furthermore, the need for the reconstruction of the dura and skull base structures has an important influence on the decision about the surgical procedure. Transfacial approaches provide limited exposure, especially when tumors damage the floor of the anterior cranial fossa and involve the frontobasal dura and brain. Transcranial, craniofacial and subcranial approaches in particular may aid a surgeon in the removal of such lesions, and often these surgical procedures are the only beneficial methods. Our study comprised 15 patients. Transcranial approaches were used in ten cases. In five further cases, we adopted craniofacial or subcranial approaches. Total removal of these lesions was possible in 13 cases. Neither important complications nor death after surgery was observed except for two cases (craniofacial/subcranial approach) where the CSF leak and CNS infection were reported. We deem that the transcranial approach creates a good possibility for total removal of anterior skull base tumors, particularly of the benign lesions, and permits reconstruction of the skull base damaged by the tumor. However, in patients with large malignant tumors, the en bloc resection via the combined craniofacial/subcranial approach achieved better outcome.
Hendryk
Stanisław
S
Department and Clinical Division of Neurosurgery and Neurotraumatology, Silesian Medical University, 41-902, Bytom, Poland. neursurg@infomed.slam.katowice.pl
Czecior
Eugeniusz
E
Misiołek
Maciej
M
Namysłowski
Grzegorz
G
Mrówka
Ryszard
R
D035262:Cranial Fossa, Anterior / Q000473:pathology / Q000601:surgery*; D005147:Facial Bones / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D018204:Neoplasms, Connective and Soft Tissue / Q000473:pathology / Q000601:surgery*; D009375:Neoplasms, Glandular and Epithelial / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D019292:Skull Base Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome