Craniofacial resection for malignant tumours involving the anterior skull base

Abstract

Ethmoid malignant tumours are rare, but nearly all at least approach or involve the lamina cribrosa. An anterior craniofacial resection is almost always mandatory for a radical resection. While almost everything has been written about technical details, few studies reported meaningful analysis about prognostic factors and long-term results, for a series of reasons: the infrequency of these tumours, the variety of histologies, small patients cohorts presented by each author, a medley of untreated and pre-treated patients, the lack of a universally accepted classification. We perform a review of the literature in the light of our experience of 330 anterior craniofacial resections for ethmoid malignant tumours. We present our classification of ethmoid malignant tumours (called INT, Istituto Nazionale Tumori). It turned out to be more prognostic than AJCC-UICC classification.

Tailored Extended Bifrontal Craniotomy for Anterior Skull Base Tumors: Anatomic Description of a Modified Surgical Technique and Case Series

“…Rates of cerebrospinal fluid leak are generally cited at 8% to 10% 12,14,15 with meningitis between 1% and 10%. 16,17 Meticulous closure and use of vascularized pericranial graft to exclude the frontal and sphenoethmoidal sinuses remain imperative steps to allow safe use of the surgical corridor presented. [18][19][20] In each case, the mucosa of the frontal sinus was removed across all areas and an antibioticsoaked gelfoam sponge placed in the cavity during the case.…”

Treatment Outcomes of Locally Advanced Squamous Cell Carcinoma of the Ethmoid Sinus Treated with Anterior Craniofacial Resection or Chemoradiotherapy

“…With respect to previously reported outcomes of craniofacial resection (CFR) for ethmoid cancers, Cantù et al [10] reported that the 5-year OS rate of patients with SCC was 21% among 330 patients with ethmoid malignant tumors treated with CFR. Salvan et al [11] reported a 5-year OS rate of 36% among 41 cases with ethmoid malignant tumors and 39% in cases with adenocarcinomas.…”

Surgery minimizing at median craniofacial tumors

“…Загальноприйнятою практикою хірургії пухлин інтра-екстракраніальної локалізації є виконання краніофаціальної резекції [1][2][3], яка передбачає здій-снення інтракраніального (як правило, біфронтальної трепанації черепа) та фаціального етапів [4][5][6][7]. Це дає змогу збільшити радикальність операції шляхом видалення пухлини одним блоком з суміжними м'якими тканинами та кістковими структурами [8,9].…”