Operative management of skull base malignant tumors arising from the nasal cavity and paranasal sinus: recent strategies used in 25 cases.
Cancers of the paranasal sinuses and nasal cavity are the most common malignant tumors of the anterior and anterolateral skull base. The treatment of these tumors affecting the skull base is complex due to the significant anatomical features. We examined 25 patients, 17 males and 8 females with mean age 61 +/- 2 years. En bloc resections using anterior skull base resection, orbital resection, middle fossa resection, and combined procedures of these three resections were performed. Using a combination of adjuvant radiation and chemotherapy, we have achieved a 2-year disease-free survival rate of 90% in these cases. However, potential complications include cerebrospinal fluid leakage, meningitis, abscess formation, pneumocephalus, frontal brain contusion, trismus, and dysphagia as a functional complication. We believe that the optimal management of such malignant tumors involves a multimodal and multidisciplinary team approach. Here we present our recent institutional experience and treatment policy employed during the past 3 years.
Jimbo
Hiroyuki
H
Skull Base Center, International University of Health and Welfare, Mita Hospital, Tokyo, Japan. hjimbo@tokyo-med.ac.jp
Kamata
Shinetsu
S
Miura
Kouki
K
Asamoto
Shunji
S
Tada
Shinichiro
S
Endo
Takahiro
T
Masubuchi
Tatsuo
T
Nakamura
Narihiro
N
Fushimi
Chihiro
C
D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy / Q000379:methods; D000075202:Contraindications; D035301:Cranial Fossa, Middle / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery; D004358:Drug Therapy / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D019635:Neurosurgical Procedures / Q000379:methods*; D009669:Nose Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D009915:Orbit / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery; D010027:Osteotomy / Q000379:methods; D010255:Paranasal Sinus Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010256:Paranasal Sinuses / Q000033:anatomy & histology / Q000473:pathology / Q000601:surgery; D010348:Patient Care Team; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011859:Radiography; D018714:Radiotherapy, Adjuvant / Q000379:methods / Q000706:statistics & numerical data; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D019291:Skull Base / Q000033:anatomy & histology / Q000473:pathology* / Q000601:surgery*; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate