Intraoperative biopsy of the major cranial nerves in the surgical strategy for adenoid cystic carcinoma close to the skull base.
OBJECTIVE
Adenoid cystic carcinoma of the salivary glands has a propensity for perineural invasion, which could favor spread along the major cranial nerves, sometimes to the skull base and through the foramina to the brain parenchyma. This study evaluated the relationship between neural spread and relapse in the skull base.


METHODS
During surgery, we performed multiple biopsies with extemporaneous examination of the major nerves close to the tumor to guide the surgical resection.


RESULTS
The percentage of actuarial local control at 5 years for patients with a positive named nerve and skull base infiltration was 12.5%, compared with 90.0% in patients who were named nerve-negative and without infiltration of the skull base (P = .001).


CONCLUSIONS
Our study shows that local control of disease for patients who are named nerve-positive with skull base infiltration is significantly more complex compared with patients who are named nerve-negative without infiltration of the skull base.
Unit of Oral and Maxillofacial Surgery, S. Orsola-Malpighi-Hospital, University of Bologna, Bologna, Italy. achilletarsitano@hotmail.it
Achille
A
Tarsitano
Angelo
A
Pizzigallo
Manlio
M
Gessaroli
Carmelo
C
Sturiale
Claudio
C
Marchetti
D000328:Adult; D000368:Aged; D001706:Biopsy; D003528:Carcinoma, Adenoid Cystic / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D003390:Cranial Nerve Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000601:surgery; D003391:Cranial Nerves / Q000473:pathology*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012086:Reoperation; D012468:Salivary Gland Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D019292:Skull Base Neoplasms / Q000378:metabolism / Q000401:mortality / Q000601:surgery; D015996:Survival Rate