Abstract
Skull base surgery for head and neck cancer invading the skull base is performed for the purpose of en bloc resection of the cancer and improving the therapeutic results. We will explain about setting the osteotomy line in the anterior and middle skull base surgery for paranasal sinus carcinoma in our procedure: the osteotomy here means that the anterior skull base bone is cut through the unaffected side ethmoidal sinus roof, the middle skull base bone is cut through the foramen ovale. And these two osteotomy are connected with the osteotomy from the upper surface of the sphenoid bone to the lateral surface of the carotid groove.
Among 30 cases that underwent the skull base surgery by the combined intra and extracranial approach, 14 cases of paranasal sinus carcinoma performed the anterior and middle skull base surgery were examined. The surgical procedure, therapeutic results and indication of the procedure to cases of the cancer invasion into cavernous sinus were examined in these 14 cases. In the approach to the cavarnous sinus, after resection of the anterior clinoid process by the orbito-zygomatic approach, the dual ring is incised and the cavernous sinus is reached from the anterolateral side along the internal carotid artery and resected in combination. First, among 8 cases that had no cavernous sinus invasion, en bloc resection was performed extradurally in 7 cases, and 5 of the 7 are alive without carrying cancer (for 93, 57, 51, 37 and 6 months).
On the other hand, of 6 cases that had cavernous sinus invasion, 3 cases are alive and 3 cases died (after 8, 7 and 20 months).
Among the surviving cases, the case who has survived for along period of 119 months had cavernous sinus invasion limited in the anterolateral portion.
