Subcranial craniofacial resection for advanced sinonasal malignant tumours involving the anterior skull base

2016 ◽  
Vol 130 (8) ◽  
pp. 743-748 ◽  
Author(s):  
C C Yong ◽  
A Soni-Jaiswal ◽  
J J Homer
Keyword(s):  
Skull Base ◽  
Disease Free Survival ◽  
Anterior Skull Base ◽  
Soft Tissue Reconstruction ◽  
Malignant Tumours ◽  
Primary Defect ◽  
Craniofacial Resection ◽  
Mortality And Morbidity ◽  
Base Extension ◽  
Sinonasal Malignancies

AbstractBackground:The subcranial approach is a modification of traditional craniofacial resection. It provides similar broad access to the anterior skull base, but with lower mortality and morbidity. It has been the surgical technique of choice at our institution since 2006 for treating advanced stage sinonasal tumours (American Joint Committee on Cancer stage III or above). This paper reports our experience and outcomes.Method and results:Eighteen patients underwent subcranial craniofacial resection over a seven-year period, this being combined with a second adjunctive procedure in 89 per cent of cases. Forty per cent of patients required reconstruction of the primary defect. No peri-operative deaths occurred. One patient had a transient cerebrospinal fluid leak. The major complication rate was 33 per cent, of which 67 per cent were directly related to soft tissue reconstruction. Tumour recurrence rate was 17 per cent and the five-year disease-free survival estimate was 40 per cent.Conclusion:The subcranial approach is a safe and effective technique that may be used to successfully treat advanced sinonasal malignancies with anterior skull base extension.

Endoscopy skull-base resection for ethmoid adenocarcinoma and olfactory neuroblastoma

2011 ◽  
Vol 49 (1) ◽  
pp. 74-79
Author(s):  
Filippo Carta ◽  
Romain Kania ◽  
Elisabeth Sauvaget ◽  
Damien Bresson ◽  
Bernard George ◽  
...  
Keyword(s):  
Skull Base ◽  
Local Control ◽  
Postoperative Radiotherapy ◽  
Disease Free Survival ◽  
Olfactory Neuroblastoma ◽  
Anterior Skull Base ◽  
Facial Skeleton ◽  
Craniofacial Resection ◽  
Free Survival ◽  
Sinonasal Malignancies

Statement of problem: Olfactory neuroblastoma (ON) and ethmoid adenocarcinoma (AC) are rare sinonasal malignancies that often involve the skull base. Standard surgical treatment is craniofacial resection (CFR), which allows for efficient removal but entails significant morbidity and mortality. Because expanded endoscopy nasal approaches are newly developed, we aimed to describe the procedure in patients with ON and AC and compare it with CFR in terms of efficiency and morbidity. Methods: This work reports on a retrospective series of 16 patients with AC and ON treated endoscopically with anterior skull-base resection in a single institution over 9 years. Invasion of the frontal sinus, massive extension to the cerebral parenchyma, spread of the tumour above the orbits or lysis of anterior facial skeleton were contraindications for endoscopy resection. Results: Of the 16 patients, 11 had AC and 5 ON. In total, 37.5% (6) exhibited skull-base invasion. All patients had postoperative radiotherapy. In the early postoperative period, one patient experienced delayed seizure due to a minor subdural hematoma. Two delayed complications were observed: one encephalocele related to inappropriate postoperative care, which required revision surgery, and one extended radionecrosis. Five-year disease-free survival was 83% and 5-year recurrence-free survival 58%. Local control rate was 91% for AC and 100% for ON. Conclusions: With low perioperative morbidity and efficient local control, ethmoidectomy combined with anterior skull-base resection is a promising approach for managing selected cases of AC and ON. These findings need further investigation with prolonged follow-up.

Craniofacial resection for malignant tumours involving the anterior skull base

2006 ◽  
Vol 263 (7) ◽  
pp. 647-652 ◽  
Author(s):  
Giulio Cantù ◽  
Stefano Riccio ◽  
Gabriella Bimbi ◽  
Massimo Squadrelli ◽  
Sarah Colombo ◽  
...  
Keyword(s):  
Skull Base ◽  
Anterior Skull Base ◽  
Malignant Tumours ◽  
Craniofacial Resection

Outcomes of Surgical Management of Sinonasal Malignancies Involving the Anterior Skull Base

2019 ◽  
Author(s):  
Gautam Mehta ◽  
Shaan Raza ◽  
Shirley Su ◽  
Michael Kupferman ◽  
Ehab Hanna ◽  
...  
Keyword(s):  
Skull Base ◽  
Surgical Management ◽  
Anterior Skull Base ◽  
Sinonasal Malignancies

scholarly journals Craniofacial resection of malignant tumors of the anterior skull base: a case series and a systematic review

2018 ◽  
Vol 160 (12) ◽  
pp. 2339-2348 ◽  
Author(s):  
Marton König ◽  
Terje Osnes ◽  
Peter Jebsen ◽  
Torstein R. Meling
Keyword(s):  
Systematic Review ◽  
Skull Base ◽  
Malignant Tumors ◽  
Case Series ◽  
Anterior Skull Base ◽  
Craniofacial Resection

Endoscopic Margins of Skull-base Tumors: Oncologically Safe?

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P37-P37
Author(s):  
Marc A. Cohen ◽  
Jonathan Liang ◽  
Bert W O'Malley ◽  
Jason G Newman
Keyword(s):  
Skull Base ◽  
Office Visit ◽  
Anterior Skull Base ◽  
Resection Margins ◽  
Skull Base Tumors ◽  
Recurrence Rates ◽  
Craniofacial Resection ◽  
Positive Margins ◽  
Increased Risk ◽  
Base Lesion

Objective 1) Learn if margins of resection in anterior skull base tumors that are entirely or endoscopic-assisted are comparable with those undergoing traditional craniofacial resection. 2) Understand if there is a difference in patient mortality with traditional CFR compared to endoscopic-assisted surgery. Methods Retrospective review was conducted of patients undergoing surgery at our institution for malignant lesions of the anterior skull base between 2000–2006. 46 patients were identified. 20 underwent endoscopic-assisted or total endoscopic resection. Margins were evaluated by the pathologist. Recurrence rates were calculated based on the presence or absence of recurrence at the last office visit. Follow-up times ranged from 1 month to 5 years. Results Of the 20 patients undergoing endoscopic or endoscopic assisted CFR of anterior skull base lesions, 15/20 patients had negative margins (75%), 4/20 had positive margins (20%), and 1/20 had close margins (5%). In those patients undergoing traditional CFR, 17/26 patients had negative margins (65%), 8/26 had positive margins (30%), and 1/26 (4%) had close margins. Recurrence was noted in 9/26 (35%) of those who underwent traditional CFR and 6/20 (30%) of those with endoscopic assistance. Conclusions There does not appear to be increased risk of positive margins or recurrence in those undergoing endscopic or endoscopic-assisted resection. Endoscopy may aid in identifying margins of tumor in the anterior skull base, leading to a greater likelihood of cure. Endoscopic resections have the potential to avoid morbity and should be considered oncologically sound in the appropriate patient with a skull base lesion.

Management of sinonasal adenocarcinomas with anterior skull base extension

2020 ◽  
Vol 150 (3) ◽  
pp. 405-417
Author(s):  
Marco Ferrari ◽  
Paolo Bossi ◽  
Davide Mattavelli ◽  
Laura Ardighieri ◽  
Piero Nicolai
Keyword(s):  
Skull Base ◽  
Anterior Skull Base ◽  
Base Extension

Comparison of transnasal endoscopic and open craniofacial resection for malignant tumors of the anterior skull base

2009 ◽  
Vol 119 (5) ◽  
pp. 834-840 ◽  
Author(s):  
Jean Anderson Eloy ◽  
Richard J. Vivero ◽  
Kimberly Hoang ◽  
Frank J. Civantos ◽  
Donald T. Weed ◽  
...  
Keyword(s):  
Skull Base ◽  
Malignant Tumors ◽  
Anterior Skull Base ◽  
Craniofacial Resection

scholarly journals Risk of Incisional Recurrence after Midface and Anterior Skull Base Surgery in Sinonasal Malignancies

Skull Base ◽  
2010 ◽  
Vol 21 (02) ◽  
pp. 087-092 ◽  
Author(s):  
Michael Moore ◽  
Derrick Lin ◽  
Daniel Deschler ◽  
Jing Wang ◽  
Annie Chan
Keyword(s):  
Skull Base ◽  
Skull Base Surgery ◽  
Anterior Skull Base ◽  
Sinonasal Malignancies

scholarly journals Minimálisan invazív, endoszkóppal asszisztált, transcribriform reszekció a koponyaalap rosszindulatú daganatainak sebészetében

2019 ◽  
Vol 160 (40) ◽  
pp. 1584-1590
Author(s):  
Zalán Piski ◽  
András Büki ◽  
Imre Gerlinger ◽  
István Tóth ◽  
Nelli Nepp ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Skull Base ◽  
Intraoperative Complications ◽  
Anterior Skull Base ◽  
Open Approach ◽  
Malignant Tumours ◽  
Recurrent Tumour ◽  
Intestinal Type Adenocarcinoma ◽  
The Mean

Abstract: Introduction: Malignant tumours of the sinonasal region – including those with invasion of the skull base – necessitate surgical resection. The majority of the cases give an opportunity to perform the procedure via minimally invasive, endoscopic approach, without external, craniofacial surgery. Aim: To assess our clinical experience in treating anterior skull base malignancies, performing minimally invasive endoscopic transcribriform resection. Method: Between February 2015 and July 2017, four male and one female patient underwent minimally invasive, endoscopic skull base procedure. The mean age was 64.6 years (59–70, median: 66). Every surgery was performed via transnasal, endoscopic transcribriform approach. In two cases Kadish C esthesioneuroblastomas, while in one case a T3N0 sinonasal non-differentiated carcinoma, a T1N0 intestinal type adenocarcinoma and a T4N0 squamous cell carcinoma was the indication of surgery, respectively. Results: The mean follow-up time was 22.8 months, between 14 and 46 months. Intraoperative complications did not occur during the procedures. Regarding the postoperative period, liquorrhoea and pneumocephalus occurred in one case. Complications were solved with lumbar drainage. During follow-up, neither residual nor recurrent tumour was observed in our patients. Conclusion: Endoscopic transcribriform resection of the skull base malignancies is a safe and viable alternative to the traditional open approach. Orv Hetil. 2019; 160(40): 1584–1590.

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