The results of surgery for malignant tumors of the skull base: A preliminary report

Abstract

Surgery for malignant tumors of the skull base has high risk of leaving micro¬scopic disease and, thus, less chance of achieving cure, and may result in serious postoperative complications, cranial nerve deficits and cosmetic deformities. The question whether the results will justify the risks of surgery remains yet to be an¬swered. In this study, between August 1992 and September 1994, a single team op¬erated on 16 patients with malignant tumors of the skull base; six patients had pri¬mary tumors and 10 had recurrent tumors. The types of tumors treated were six squamous cell carcinomas, four invasive basal cell carcinomas, three adenoid cys¬tic carcinomas, one acinic cell carcinoma and two sarcomas. Radical tumor resec¬tion could be achieved in 14 patients; however, in two patients macroscopic tumor was left in the contralateral cavernous sinus not to endanger the patient with life-threatening complications. Reconstruction of the facial skin and skeleton was done satisfactorily using local flaps, pediced flaps and free vascularized flaps. Post¬operative complications were permanent facial nerve palsy and temporary cere-brospinal fluid leakage in one patient, and partial flap necrois in three patients. The patients in our series had an overall survival rate of 81% for the mean follow-up period of 13 months and ultimate local control was accomplished in 69% of the cases. The results indicate that surgery for malignant tumors of the skull base im¬proves the control of local disease and may provide extended periods of palliation.