Objectives
Oral and maxillofacial tumors involving the skull base (SB) are rare and complex,
making treatment difficult and controversial. The purpose of the present study was
to evaluate the treatment efficacy of craniofacial surgery (CFS).
Study Design
Patients who underwent CFS for these tumors between May 2000 and November 2017 were
retrospectively analyzed. Clinicopathologic and treatment modality data were collected
and follow-up was recorded. Kaplan-Meier and log-rank tests and Cox-regression model
were used for survival analysis.
Results
In total, 126 patients were enrolled (70 males and 56 females; 97 malignant tumors).
Squamous cell carcinoma accounted for the majority of tumors. The lip–submandibular–neck
approach was most frequently applied. Through-and-through SB bone or partial dura
resection was performed in 42 cases. A pathologic positive margin was found in 18
cases. Of the included patients, 80 underwent simultaneous craniofacial reconstruction.
The postoperative complications rate was 11.1%. Estimated 1-year, 3-year, and 5-year
overall survival rates were 78.8%, 68.2%, and 54.4% respectively; and the 1-year,
3-year, and 5-year recurrence-free survival rates were 77.4%, 66.8%, and 63.8%, respectively.
Multivariate analysis indicated postoperative complications, radiotherapy, recurrence,
and metastasis status had a negative impact on survival (P < .05).
Conclusions
Although tumors involving the SB had various clinicopathologic characteristics, with
interdisciplinary cooperation, CFS is an optimal option.
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References
- The trans naso-orbito-maxillary approach to the anterior and middle skull base.Int J Oral Maxillofac Surg. 1998; 27: 53-57
- Endonasal endocopic approaches to the paramedian skull base.World Neurosurg. 2014; 82: S121
- History of skull base surgery.Sukll Base Surg. 1991; 1: 1-3
- Skull base tumors: a kaleidoscope of challenge.J Neurol Surg Rep. 2014; 75: e11-e21
- Is there a role for craniofacial surgery in the treatment of extensive or recurrent head and neck tumors involving the cranial base?.J Oral Maxillofac Surg. 2017; 75: 2006-2019
- Advantage of extended craniofacial resection for advanced malignant tumors of the nasal cavity and paranasal sinuses: long-term outcome and surgical management.World Neurosurg. 2016; 89: 240-254
- The safety and accuracy of surgical navigation technology in the treatment of lesions involving the skull base.J Craniofac Surg. 2017; 28: 1431-1434
- Transfacial approaches to the skull base: the early contributions of Harvey Cushing.Skull Base. 2011; 21: 207-214
- A combined intracranial facial approach the paranasal sinuses.Am J Surg. 1963; 1963: 698-703
- Craniofacial approaches and reconstruction in skull base surgery: techniques for the oral and maxillofacial surgeon.J Oral Maxillofac Surg. 2013; 71: 2137-2150
- Craniofacial resection and reconstruction in patients with recurrent cancer involving the craniomaxillofacial region.J Oral Maxillofac Surg. 2017; 75: 622-631
- Skull base erosion resulting from primary tumors of the temporomandibular joint and skull base region: our classification and reconstruction experience.J Oral Maxillofac Surg. 2018; 76: 1345-1354
- Surgical management and follow-up of lateral skull base tumors: an 8-year review.Mol Clin Oncol. 2017; 6: 214-220
- Craniofacial surgery for malignant skull base tumors: report of an international collaborative study.Cancer. 2003; 98: 1179-1187
- Management of lateral skull base cancer: United Kingdom National Multidisciplinary Guidelines.J Laryngol Otol. 2016; 130: S119-S124
- Interdisciplinary reconstruction of oncological resections at the skull base, scalp and facial region.Surg Oncol. 2017; 26: 318-323
- Malignant tumors of the skull base.Neurosurg Focus. 2002; 13: e6
- Prognostic significance of trandural invasion of cranial base malignancies in patients undergoing craniofacial resection.Neurosurgery. 2007; 61: 1178-1185
- Six-year retrospective study of reconstructive options for defects of the skull base after resection of tumour.Br J Oral Maxillofac Surg. 2013; 51: 719-724
- The use of free flaps in skull base reconstruction.Int J Oral Maxillofac Surg. 2016; 45: 158-162
- Free flap transfer in cranio-maxillofacial surgery: a review of the current data.Oral Maxillofac Surg. 2008; 12: 113-124
- Evaluation of reconstructive techniques for anterior and middle skull base defects following tumor ablation.J Oral Maxillofac Surg. 2014; 72: 198-204
- Endoscopic nasal versus open approach for the management of sinonasal adenocarcinoma: a pooled analysis of 1826 patients.Head Neck. 2016; 38: E2267-E2274
- Costs and perioperative outcomes associated with open versus endoscopic resection of sinonasal malignancies with skull base involvement.J Neurol Surg B Skull Base. 2017; 78: 430-440
- Expanded endoscopic endonasal approach for anterior cranial base and suprasellar lesions: indications and limitations.Neurosurgery. 2009; 64: 697-699
- Advantages and limitations of endoscopic endonasal approaches to the skull base.World Neurosurg. 2014; 82: S12-S21
- Classification of facial translocation approach to the skull base.Otolaryngol Head Neck Surg. 1995; 112: 579-585
- Complications of craniofacial resection for malignant tumors of the skull base: report of an International Collaborative Study.Head Neck. 2005; 27: 445-451
- Complications of resection of malignant tumours of the skull base: outcome and solution.Eur Arch Otorhinolaryngol. 2007; 264: 733-739
Article info
Publication history
Published online: July 15, 2020
Accepted:
June 5,
2020
Received in revised form:
May 4,
2020
Received:
February 22,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.