title: Combined craniofacial resection of anterior skull base tumors: long-term results and experience of single institution.
abstract: In this article, the authors are presenting their experience and the results with combined craniofacial resection of anterior skull base tumors based on a review of 27 constitutive cases. Our data are evaluated in comparison to other major centers in other parts of the world, and possible factors that might influence surgical outcome and survival are discussed. Twenty-seven patients diagnosed with anterior skull base tumors between 1999 and 2009 were treated by combined craniofacial resection. Of these patients, there were 19 males (70, 3%) and eight females (29, 7%). The age ranged between 11 and 75 years (mean = 45.9 ± 17.6 years). The follow-up period ranged between 14 and 123 months (avarage = 74 months). The most common presenting symptoms were nasal obstruction and vision disturbance (11 patients for each -40.7%). Total resection was achieved in 24 patients (89%), while subtotal resection was done in three patients (11%). The most common complication was CSF fistule with rhinorrhea, which occurred in five patients (18.5%). Eight patients had recurrences at the time of this long-term follow-up. There were two mortalities in the early postoperative period and seven deaths in the long-term follow-up (overall mortality, 33.3%). The overall 5-year overall survival for all patients in our series was 70.4%. The 5-year overall survival was 62% for patients with malignant tumors and 100% for patients with benign tumors. Combined craniofacial resection of tumors of the anterior skull base is an effective approach for the management of these pathologies. The effectiveness is clearly demonstrated by the clinical results and outcomes of these patients' groups. The favorable prognosis is enhanced by significantly by total resection with negative tumor margins.
authors.affiliation: Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa Street, K.M. Pasa, Fatih, Istanbul, Turkey, PO Box: 34089. sylvius@live.com
authors.forename: Bashar
authors.initials: B
authors.lastname: Abuzayed
authors.forename: Bulent
authors.initials: B
authors.lastname: Canbaz
authors.forename: Galip Zihni
authors.initials: GZ
authors.lastname: Sanus
authors.forename: Seckin
authors.initials: S
authors.lastname: Aydin
authors.forename: Harun
authors.initials: H
authors.lastname: Cansiz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D002648:Child; D005145:Face / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006257:Head / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000209:etiology; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D019635:Neurosurgical Procedures / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D019292:Skull Base Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology; D055815:Young Adult