Rate of Development of Venous Thromboembolism in Lateral Skull Base Surgery

AbstractThe management of lesions of the lateral skull base is a highly sophisticated branch of surgery generally performed by otolaryngology–head and neck surgeons as part of a multi-disciplinary team. Assessment of patients with diseases affecting the lateral skull base can be complex, as can the application of the various treatment modalities and the management of the expected and unexpected side effects of that treatment.A wide range of pathological conditions occur in the lateral skull base. Many operations and procedures have been described for dealing with them. There is not necessarily one correct solution to the management of any particular problem in the skull base, with multiple factors to be considered in planning and intervention.As surgeons, we need to know how our own results and outcomes compare with pooled, published data concerning the implications and complications occurring as a result of intervention, in order to better advise our patients on their management.

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Anatomical study of occipital triangles: the ‘inferior’ suboccipital triangle, a useful vertebral artery landmark for safe postero-lateral skull base surgery

Acta Neurochirurgica ◽

10.1007/s00701-017-3300-3 ◽

2017 ◽

Vol 159 (10) ◽

pp. 1887-1891 ◽

Cited By ~ 8

Author(s):

Giuseppe La Rocca ◽

Roberto Altieri ◽

Luca Ricciardi ◽

Alessandro Olivi ◽

Giuseppe Maria Della Pepa

Keyword(s):

Vertebral Artery ◽

Skull Base ◽

Skull Base Surgery ◽

Anatomical Study ◽

Lateral Skull Base

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Atlas of temporal bone and lateral skull base surgery

American Journal of Otolaryngology ◽

10.1016/s0196-0709(97)90110-1 ◽

1997 ◽

Vol 18 (2) ◽

pp. 155-156

Author(s):

Stephen P. Cass

Keyword(s):

Skull Base ◽

Temporal Bone ◽

Skull Base Surgery ◽

Lateral Skull Base

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Path Planning for Multi-port Lateral Skull Base Surgery Based on First Clinical Experiences

Clinical Image-Based Procedures. Translational Research in Medical Imaging - Lecture Notes in Computer Science ◽

10.1007/978-3-319-05666-1_4 ◽

2014 ◽

pp. 23-30

Author(s):

Meike Becker ◽

Stefan Hansen ◽

Stefan Wesarg ◽

Georgios Sakas

Keyword(s):

Path Planning ◽

Skull Base ◽

Skull Base Surgery ◽

Clinical Experiences ◽

Lateral Skull Base

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Audit of Complications in an Otolaryngology Led Skull-Base Surgical Practice

Journal of Neurological Surgery Part B Skull Base ◽

10.1055/s-0038-1676793 ◽

2018 ◽

Vol 80 (06) ◽

pp. 586-592

Author(s):

Uma Patnaik ◽

Smriti Panda ◽

Alok Thakar

Keyword(s):

Skull Base ◽

Surgical Complications ◽

Skull Base Surgery ◽

Major Complication ◽

Anterior Skull Base ◽

Complication Rates ◽

Permanent Disability ◽

Lateral Skull Base ◽

Significant Difference ◽

Surgical Complexity

Objective This study was aimed to classify and study complications of surgery of the cranial base, primarily from an otorhinolaryngology perspective. Design This study was designed with consecutive cohort of skull base surgical cases. Setting Tertiary referral academic center. Participants Patients having skull-base surgery at a otorhinolaryngology based skull-base unit, from 2002 to 2015. Main Outcome Measures Enumeration of complications is the main outcome of this study. Surgical procedures, categorized for complexity as per a unified system, are applicable to endoscopic and open procedures. Complications were categorized as per the British Association of Otolaryngologists coding of surgical complications. Complication classified as major if life-threatening, causing permanent disability, or compromising the result of surgery. Results A total of 342 patients (n = 342) were operated; 13 patients' records were excluded due to < 6 months posttreatment follow-up. The study group constituted 204 anterior skull-base (endoscopic, 120; open/external, 84) and 125 lateral skull-base procedures. Complication rates noted to increase in both groups with increasing complexity of surgical intervention. Anterior skull-base surgery (total complications, 11%; major, 3%; death, 0.5%) noted to have significantly less surgical complications than lateral skull-base surgery (total complications, 33%; major, 15%; death, 1.6%; p < 0.001). Among the anterior procedures no significant difference noted among endoscopic and external approaches when compared across similar surgical complexity. Conclusion Despite improvement in surgical and perioperative care, the overall major complication rate in a contemporary otolaryngology led, primarily extradural, skull-base practice is noted at 8%. Perioperative mortality, though rare, was encountered in 1%. A standard method for categorization of surgical complexity and the grade of complications as reported here is recommended.

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