The radical resection of the head and neck tumors that have invaded the cranial base requires an en-block resection that includes the dura and the cranial base. However, a reliable reconstruction method of the dura and the cranial base is necessary after that resection. From 1984, the anthors have undertaken the cranial base reéonstructions in fifteen cases, using pedicled musculopericranial flaps. This paper, reports the reliability and the usefulness of the musculopericranial flaps in the cranial base reconstruction. Futhermore, this paper discusses the cosmetic results after the cranial base surgery.
A role of anticancer chemotherapy for advanced head and neck cancer was analyzed from a view point of chemosensitivity. There were some problems in the sensitivity test such as low evaluable rate and low rate of clinical application. However, true positive and negative rate was 77% (10/13) in case of clinical application was possible, and chemotherapy eventually contributed to keep up the quality of life excluding invalid drugs. Cases over 80 years of age, who refused to undergo surgical treatment, will be preferable cases for chemotheraoy. An evaluation of neo-adjuvant chemotherapy was reviewed from papers reported. A tentative conclusion was that chemotherapy has contributed to keep up the QOL but not for improvement of 5 year survival rate.