gms | German Medical Science

For malignant tumours arising from the skull base, surgical resection is frequently employed either as the primary treatment modality or as a salvage procedure. As these tumours exhibit a wide range of pathologies thus the strategy of surgical treatment also varies accordingly.

For tumours located in the anterior skull base, combined craniofacial resection has been the standard surgical approach. For those malignant tumours located at central skull base, we have employed the anterolateral (maxillary swing) approach for their removal. Besides systemic morbidities, the complications following the resection of these malignant skull base tumours could be categorized according to the time of occurrence. Central nervous system problems and injury of vital structures such as the orbit or cranial nerves usually present early while those related to functional or aesthetic aspects usually occur late. The development of local recurrent tumour might also be counted as a late complication of the procedure.

From an international collaborative study of 17 Institutions which included the database of our department, 1193 patients were included. They underwent combined craniofacial resection and over 80% of tumours were located in the anterior skull base, the overall mortality was 4.7% (56/1193) and the 5-year disease free survival rate was 53%. The overall complication rate reported was 36% (433/1193) and among them, wound problem was most frequently seen, 20% (237/1193) followed by central nervous system complications, 16% (193/1193).