Operative management of skull base malignant tumors arising from the nasal cavity and paranasal sinus: recent strategies used in 25 cases

Neurol Med Chir (Tokyo). 2010 Jan;50(1):20-6; discussion 26. doi: 10.2176/nmc.50.20.

Abstract

Cancers of the paranasal sinuses and nasal cavity are the most common malignant tumors of the anterior and anterolateral skull base. The treatment of these tumors affecting the skull base is complex due to the significant anatomical features. We examined 25 patients, 17 males and 8 females with mean age 61 +/- 2 years. En bloc resections using anterior skull base resection, orbital resection, middle fossa resection, and combined procedures of these three resections were performed. Using a combination of adjuvant radiation and chemotherapy, we have achieved a 2-year disease-free survival rate of 90% in these cases. However, potential complications include cerebrospinal fluid leakage, meningitis, abscess formation, pneumocephalus, frontal brain contusion, trismus, and dysphagia as a functional complication. We believe that the optimal management of such malignant tumors involves a multimodal and multidisciplinary team approach. Here we present our recent institutional experience and treatment policy employed during the past 3 years.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Combined Modality Therapy / methods
  • Contraindications
  • Cranial Fossa, Middle / anatomy & histology
  • Cranial Fossa, Middle / pathology
  • Cranial Fossa, Middle / surgery
  • Drug Therapy / methods
  • Drug Therapy / statistics & numerical data
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / prevention & control
  • Neurosurgical Procedures / methods*
  • Nose Neoplasms / diagnostic imaging
  • Nose Neoplasms / pathology
  • Nose Neoplasms / surgery*
  • Orbit / anatomy & histology
  • Orbit / pathology
  • Orbit / surgery
  • Osteotomy / methods
  • Paranasal Sinus Neoplasms / diagnostic imaging
  • Paranasal Sinus Neoplasms / pathology
  • Paranasal Sinus Neoplasms / surgery*
  • Paranasal Sinuses / anatomy & histology
  • Paranasal Sinuses / pathology
  • Paranasal Sinuses / surgery
  • Patient Care Team
  • Plastic Surgery Procedures / methods
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology
  • Postoperative Complications / prevention & control
  • Radiography
  • Radiotherapy, Adjuvant / methods
  • Radiotherapy, Adjuvant / statistics & numerical data
  • Retrospective Studies
  • Skull Base / anatomy & histology
  • Skull Base / pathology*
  • Skull Base / surgery*
  • Skull Base Neoplasms / diagnostic imaging
  • Skull Base Neoplasms / pathology
  • Skull Base Neoplasms / surgery*
  • Survival Rate