Maxillary removal and reinsertion: a favorable approach for extensive anterior cranial base tumors.
OBJECTIVE
To analyze the long-term results and the complications related to an expanded series of maxillary removal and reinsertion (MRRI) with 18-year surgical experience.


METHODS
Case series with chart review of the MRRI patients in the last 18 years.


METHODS
The Ohio State University Comprehensive Cancer Center, James Cancer Hospital and Solove Research Institute.


METHODS
Seventy-eight patients who underwent MRRI from February 1990 through February 2007. The median age was 51 years (range 11-77 yrs). Sixty-two (80%) patients had malignant lesions.


RESULTS
MRRI has been successfully completed in all 78 patients, with no intraoperative mortality. The most commonly encountered malignant neoplasm was squamous cell cancer (40.3%), followed by esthesioneuroblastoma (24.1%), adenoid cystic cancer (8%), and other neoplasms (27.4%). The most commonly encountered postoperative complication was diplopia, which has persisted in five (6.4%) patients in the short-term and in three (4%) patients in the long-term follow-up. Nasal asymmetry was the most common long-term complication (17.9%), followed by plate-associated problems (10.2%) and midface asymmetry (10.2%). Overall five-year survival for the patients with squamous cell carcinoma was 62 percent.


CONCLUSIONS
MRRI is a favorable surgical technique for the treatment of anterior cranial base (ACB) tumors in adults and even in children. It improves operative morbidity by preserving both function and form of the maxillary region and gives excellent exposure to ACB.
Ozer
Enver
E
Department of Otolaryngology-Head and Neck Surgery, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Comprehensive Cancer Center, the Ohio State University, Columbus, OH, USA. enver.ozer@osumc.edu
Bapna
Sumit
S
Agrawal
Amit
A
Schuller
David E
DE
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D002648:Child; D035262:Cranial Fossa, Anterior; D018304:Esthesioneuroblastoma, Olfactory / Q000601:surgery; D006801:Humans; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D019292:Skull Base Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult