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

Published online by Cambridge University Press:  04 July 2016

C C Yong ,
A Soni-Jaiswal  and
J J Homer
C C Yong*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Manchester Academic Health Sciences Centre, Manchester Royal Infirmary, UK
A Soni-Jaiswal
Affiliation:
Department of Otolaryngology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
J J Homer
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Manchester Academic Health Sciences Centre, Manchester Royal Infirmary, UK
*
Address for correspondence: Dr Chin Chean Yong, Department of Otolaryngology – Head and Neck Surgery, Manchester Academic Health Sciences Centre, Manchester Royal Infirmary, Manchester M13 9WL, UK E-mail: [email protected]
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Abstract

Background:

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.

Keywords

Subcranial ResectionCraniofacial ResectionParanasal Sinus Neoplasm
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 130 , Issue 8 , August 2016 , pp. 743 - 748
Copyright
Copyright © JLO (1984) Limited 2016 

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References

1 Smith, R, Klopp, C, Williams, J. Surgical treatment of cancer of the frontal sinus and adjacent areas. Cancer 1954;7:991–4Google Scholar
2 Ketcham, A, Wilkins, R, Van Buren, J, Smith, R. A combined intracranial facial approach to the paranasal sinuses. Am J Surg 1963;106:698–703 CrossRefGoogle Scholar
3 Ganly, I, Patel, SG, Singh, B, Kraus, DH, Bridger, PG, Cantu, G et al. Craniofacial resection for malignant paranasal sinus tumours: report of an international collaborative study. Head Neck 2005;27:575–84CrossRefGoogle ScholarPubMed
4 Raveh, J, Turk, J, Lädrach, K, Seiler, R, Godoy, N, Chen, J et al. Extended anterior subcranial approach for skull base tumors: long-term results. J Neurosurg 1995;82:1002–10CrossRefGoogle ScholarPubMed
5 Pepper, JP, Ward, PD, Lin, EM, Sullivan, SE, Hecht, SL, Marentette, LJ. Perioperative outcomes in patients undergoing the transglabellar/subcranial approach to the anterior skull base. Skull Base 2011;21:215–22CrossRefGoogle Scholar
6 Ross, DA, Marentette, LJ, Moore, CE, Switz, KL. Craniofacial resection: decreased complication rate with a modified subcranial approach. Skull Base Surg 1999;9:95–100 Google Scholar
7 Kellman, RM, Lawrence, M. The transglabellar/subcranial approach to the anterior skull base: a review of 72 cases. Arch Otolaryngol Head Neck Surg 2001;127:687–90CrossRefGoogle Scholar
8 Fliss, DM, Abergel, A, Cavel, O, Margalit, N, Gil, Z. Combined subcranial approaches for excision of complex anterior skull base tumors. Arch Otolaryngol Head Neck Surg 2007;133:888–96CrossRefGoogle ScholarPubMed
9 Howard, DJ, Valerie, JL, William, IW. Craniofacial resection for tumors of the nasal cavity and paranasal sinuses: a 25-year experience. Head Neck 2006;28:867–73Google Scholar
10 Ketcham, AS, Hoye, RC, Van Buren, JM, Johnson, RH, Smith, RR. Complications of intracranial facial resection for tumors of the paranasal sinuses. Am J Surg 1966;112:591–6CrossRefGoogle ScholarPubMed
11 Deschler, DG, Gutin, PH, Mamelak, AN, McDermott, MW, Kaplan, MJ. Complications of anterior skull base surgery. Skull Base Surg 1996;6:113–18CrossRefGoogle ScholarPubMed
12 Cantu, G, Solero, CL, Miceli, R, Mattana, F, Riccio, S, Colombo, S. Anterior craniofacial resection for malignant paranasal tumors: a monoinstitutional experience of 366 cases. Head Neck 2012;34:78–87 CrossRefGoogle ScholarPubMed
13 Suh, JD, Ramakrishnan, VR, Chi, JJ, Palmer, JN, Chiu, AG. Outcomes and complications of endoscopic approaches for malignancies of the paranasal sinuses and anterior skull base. Ann Otol Rhinol Laryngol 2013;122:54–9Google Scholar
14 Hanna, E, DeMonte, F, Ibrahim, S, Roberts, D, Levine, N, Kupferman, M. Endoscopic resection of sinonasal cancers with and without craniotomy: oncologic results. Arch Otolaryngol Head Neck Surg 2009;135:1219–24CrossRefGoogle ScholarPubMed