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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: cchin@nhs.net
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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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