Resection of anterior skull base tumors: comparison of combined traditional and endoscopic techniques.
BACKGROUND
Traditional craniofacial resection (tCFR) has been used successfully for resection of anterior skull base (ASB) tumors. Minimally invasive endoscopic resection (MIER) also has been used recently; this strategy facilitates superior visualization, avoids facial incisions, and preserves local structures. The goal of this study was to compare the outcome for these two approaches.


METHODS
Retrospective chart analysis was conducted to identify patients undergoing resection of ASB tumors between January 1995 and January 2003. Demographic data, tumor characteristics, and the surgical approach used were determined. The mean operative time, estimated blood loss, hospital stay, and complications were analyzed. Recurrence and mortality rates were calculated.


RESULTS
Nine patients were managed with the MIER approach, and 16 patients were treated with the traditional open approach. No significant difference was observed between groups on operative time, estimated blood loss, or hospital stay. Major complications were encountered in 2/9 (22%) and 7/16 (44%) patients in the MIER and tCFR groups, respectively. Recurrence was observed in 3/9 (33%) and 5/14 (36%) of the patients in the MIER and tCFR groups, respectively. Mortality rates in the MIER and tCFR groups were 0/9 (0%) and 4/15 (27%), respectively.


CONCLUSIONS
In this preliminary study, MIER of ASB neoplasia did not differ significantly from tCFR in operative time, estimated blood loss, hospital stay, or complication rate. Survival and recurrence rates were similar also. This early experience suggests that MIER is a viable alternative for the surgical management of ASB lesions in appropriately selected patients.
Batra
Pete S
PS
Head and Neck Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Citardi
Martin J
MJ
Worley
Sarah
S
Lee
Joung
J
Lanza
Donald C
DC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003399:Craniotomy; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications; D019291:Skull Base / Q000601:surgery*; D015996:Survival Rate