title: Physical morbidity by surgical approach and tumor location in skull base surgery.
abstract: BACKGROUND
  Skull base tumors are associated with physical symptoms that vary depending on location and surgical approach.
  
  
  METHODS
  Skull base surgery patients (n = 138) were retrospectively reviewed and physical symptoms were quantified. Patients were divided into 4 groups by surgical approach (open, endoscopic) and tumor location (anterior, central). Multivariate analyses determined odds for symptom development.
  
  
  RESULTS
  Patients with anterior lesions presented with more nasal symptoms compared to those with central lesions (63% vs 6.8%; p < .001). Those with central lesions presented with more neurologic (41.1% vs 12.3%; p < .001) and endocrine symptoms (19.2% vs 0%; p < .001). Three of 4 groups experienced a reduction in neurologic and visual symptoms after surgery. One group (endoscopic/central) experienced a reduction in endocrine and an increase in nasal symptoms. Anterior tumors (p = .02) and endoscopic approaches (p = .002) predicted increased nasal morbidity.
  
  
  CONCLUSIONS
  Physical morbidity from skull base tumors may vary based on tumor location and surgical approach.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, Canada.
authors.forename: John R
authors.initials: JR
authors.lastname: de Almeida
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Witterick
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Gullane
authors.forename: Fred
authors.initials: F
authors.lastname: Gentili
authors.forename: Lynne
authors.initials: L
authors.lastname: Lohfeld
authors.forename: Jolie
authors.initials: J
authors.lastname: Ringash
authors.forename: Achilles
authors.initials: A
authors.lastname: Thoma
authors.forename: Allan D
authors.initials: AD
authors.lastname: Vescan
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D019291:Skull Base / Q000473:pathology* / Q000601:surgery; D019292:Skull Base Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery