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Anterior Skull Base Surgery (anterior + skull_base_surgery)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Anterior skull base surgery for malignant tumors: A multivariate analysis of 27 years of experience,

HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 7 2003
Brandon G. Bentz MD
Abstract Introduction. Few studies have examined prognostic factors that have an impact on outcomes in anterior skull base surgery by multivariate analysis. Methods. We retrospectively examined our institution's skull base experience from 1973,2000. Results. During this time, 166 patients underwent an anterior skull base resection for malignancy (median age, 53 years; range, 6,92 years). The 5-year relapse-free and disease-specific survival was 41% and 57% (median follow-up, 53 months). Multivariate analysis found that dural invasion, primary histologic diagnosis, and margin status had a significant impact on relapse-free and disease-specific survival. Conclusions. These data indicate that patients with anterior skull base malignancies are treated successfully with skull base surgery. Patients demonstrating adverse prognostic variables such as dural invasion, adverse histologic findings, and/or positive margins should be considered for the addition of adjuvant therapy or innovative therapies as they become available in the future. © 2003 Wiley Periodicals, Inc. Head Neck 25: 515,520, 2003 [source]

A Rational Approach to the Use of Tracheotomy in Surgery of the Anterior Skull Base

THE LARYNGOSCOPE, Issue 2 2008
FRCS(C), Yadranko Ducic MD
Abstract Objective: To offer an algorithm for airway management in anterior skull base surgery. Methods: This is a retrospective review of 109 patients undergoing major anterior skull base surgery from a single senior surgeon's experience from September 1997 to May 2006. Results: We report only one (1%) postoperative mortality in this series and only seven major complications in six patients, including two cases of stroke, one case of cerebrospinal fluid (CSF) leak, and four cases of delayed osteoradionecrosis. No patients in this series developed tension pneumocephalus. The total major complication rate is 6%. Fifty-one (47%) patients received prophylactic tracheotomy, and 58 (53%) patients did not receive prophylactic tracheotomy. Eighty-eight (81%) patients received anterior skull base reconstruction with local flaps. Six (5.5%) patients required primary reconstruction with a free flap. Conclusion: We attribute the very low rate of major complications in this series and, in particular, no cases of tension pneumocephalus and rarity of CSF leaks primarily to prophylactic tracheotomy in selected patients and to a reconstructive strategy that emphasizes use of local vascularized tissue to reconstruct the anterior skull base. [source]