Abstract
En bloc resction of 25 malignant tumors involving the skull base was performed using multidisciplinary craniofacial approaches. Origins of tumors were from the maxillary sinus in 7 patients, from the orbit in 6, from the nasal cavity or other paranasal sinuses in 5, from the ear in 3, and others in 4. Eleven of the tumors were recurrent. When the tumor reached the skull base but did not penetrate the bone (n=11), osteotomy of the skull base was performed extradurally and the tumor was resected with the skull base bone as a tumor-free margin. When the tumor destroyed the bone and reached the dura mater (n=6), it was resected with the dura mater overlying the affected bone. When the tumor invaded the brain (n=8), the brain and dura mater adjacent to the tumor were separated from more distant normal tissue and removed together with the skull base tumor en bloc. Overall 2- and 5-year survival rates of 25 patiens were 72% and 47%, respectively. Two-year survival rates were 81% for patients without dura or brain resection, 63% for patients wuth dural resection, and 71% for patients with brain resection: there were no significant differences among these groups. By comparison, 2-year survival rates were 50% for patients with maxillary carcionmas and 33% for patients with tumors entirely involving the cavernous sinus: these factors significantly affected the outcome.
