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