THE SURGICAL-MANAGEMENT OF OSSEOUS CRANIAL BASE TUMORS IN CHILDREN

Background: Osseous cranial base rumours in children present as a dive rse collection of both benign and malignant pathologies. Concerns rais ed by the difficulty in accurate diagnosis and local recurrence of ben ign lesions and by the long-term sequelae of radiotherapy for malignan t cranial rumours (marked local growth disturbances, pituitary dysfunc tion, visual disturbances, late new tumour induction) prompted an eval uation of surgical resection of cranial base tumours in children. with specific regard to safety, efficacy and aesthetic result. Methods: A retrospective review was performed of 10 consecutive children presenti ng with tumours either arising from or eroding into bone of the crania l base who were managed by surgical resection in a 10-year period from 1986 to 1996. The patients demonstrated a great variation in both pre sentation and pathology. All underwent surgical resection of tumour wi th reconstruction where indicated. Results: There were no postoperativ e complications or mortality. All patients remained clinically free of disease at follow-up, which ranged from 17 months to 9 years (mean 6 years and 4 months). Conclusion: The aggressive surgical resection and craniofacial reconstruction of cranial base rumours in the paediatric population offers a safe and efficacious mode of treatment that obvia tes problems of diagnosis and local recurrence for benign lesions and of the long-term sequelae of radiotherapy for malignant lesions.