Changing patterns of tracheotomy use in anterior skull base surgery with free tissue reconstruction

Myers, Larry L.; Sumer, Baran D.; Lowery, Jamel E.; Truelson, John M.; Leach, Joseph L.; Sinard, Robert J.

doi:10.1002/lary.20059

Cited by 2 publications

(1 citation statement)

References 15 publications

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“…In accordance with current principles of airway management in skull base surgery, the routine placement of a tracheostomy for airway diversion is felt to be unnecessary. 25,26 Overall, we observed five episodes of tension pneumocephalus in this review. Nasopharyngeal stents are associated with lower rates of tension pneumocephalus 17 and may underlie the relatively low rate of this complication over the period reviewed (3.0%).…”

Section: Discussionmentioning

confidence: 76%

Perioperative Outcomes in Patients Undergoing the Transglabellar/Subcranial Approach to the Anterior Skull Base

et al. 2011

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We analyzed the effect of predefined patient demographic, disease, and perioperative variables on the rate of complications in the perioperative period following subcranial surgery for anterior skull base lesion. A secondary goal of this study was to provide a benchmark rate of perioperative mortality and morbidity through comprehensive analysis of complications. Retrospective review of a consecutive series of patients (n ¼ 164) who underwent the transglabellar/subcranial approach to lesions of the anterior skull base between December 1995 and November 2009 in a tertiary referral center. Main outcome measures were perioperative morbidity and mortality. No perioperative mortalities were observed over the period of consecutive review. The overall complication rate was 28.7%, with 30 (18%) patients experiencing major complication. Multivariate analysis revealed that the following variables were independent predictors of perioperative complication of any type: positive margins on final pathology, perioperative lumbar drain placement, and dural invasion. The subcranial approach provides excellent access to the anterior skull base with zero mortality and acceptable morbidity in comparison with other contemporary open surgical approaches. It should be considered a procedure with distinct advantages in terms of perioperative morbidity and mortality when selecting a therapeutic approach for patients with anterior skull base lesions.

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Section: Discussionmentioning

confidence: 76%