CRANIAL BASE SURGERY RESULTS IN 183 PATIENTS (REPRINTED FROM OTOLARYNGOLOGY-HEAD NECK-SURGERY)

Objective - To learn about the effects of cranial base surgery. Design - Cohort study with a mean follow-up of 30 months. Setting - Populati on-based. Patients - A consecutive sample of 183 patients who underwen t cranial base surgery; 118 patients had malignant skull base tumors, majority were previously treated; 50 had benign tumors, 9 patients had congenital malformations of the skull base; 3 patients had inflammato ry lesions, and 3 had traumatic defects of the skull base. Main outcom e measures - Disease-free interval and overall survival as well as rat e of complications and functional status Intervention - Cranial base s urgery was followed by radiotherapy (in previously untreated patients) . Results - After completion of follow-up (30 months, mean), 30 (25.4% ) patients had died of their malignant tumors and 8 (6.8%) had died of other causes. One patient (0.84%) was lost to follow-up. The overall cancer survival without regard to histologic type was 67% (63% with no evidence of disease). Among the patients who were treated for benign neoplasm 72% were NED at a mean 39 months of follow-up. The group of p atients with congenital malformations, inflammatory, and traumatic les ions demonstrated successful correction of their pre-surgical problem with skull base surgery. One patient (invasive aspergillosis) died of disease. The overall surgical/medical mortality was 2%, complication r ate was 33% and Karnofsky performance scale was improved or unchanged postoperatively in 83% of patients. The average duration of surgery, n umber of blood transfusions used and the length of the hospital stay w as 10 hours, 3 units, and 15 days respectively. Conclusions - Cranial base surgery is a valid surgical technique for cranial base affliction s. In this study it was found to be beneficial in controlling benign a s well as malignant disease and be the treatment of choice in selected congenital malformations, trauma, and inflammatory lesions.