Objective: This study aimed to examine predictive factors and treatment out
come and to devise a staging method for malignant lateral skull base diseas
e.
Study Design: The study design was a retrospective review of all lateral sk
ull base surgery cases.
Setting: The study was conducted at a tertiary referral center.
Patients: Of 317 lateral skull base lesions, 81 patients were found to have
malignant disease. Three groups were identified, and the data were analyze
d according to the following: epithelial malignancies, 30 patients; maligna
ncies of salivary gland origin, 23 patients; and malignancies of mesenchyma
l origin, 28 patients. The mean age was 48.5 years with a range of 5-83 yea
rs. There were 42 males and 39 females. Our mean followup time was 54 month
s with a range of 1-180 months. Forty-three patients were alive without evi
dence of recurrent disease, 6 were living with disease, 25 were dead of dis
ease, 3 died of other causes, and 4 were lost to follow-up,
Interventions: All patients underwent surgery with curative intent. Forty-t
wo received adjuvant radiation, and 8 received chemotherapy.
Main Outcome Measures: Treatment failure, survival, cranial nerve deficits,
complications, and predictive factors were analyzed.
Results: A 58% treatment success rate was observed. Epithelial and salivary
malignancy had a poorer prognosis, and pain and facial nerve dysfunction a
t presentation carried a worse prognosis.
Conclusions: Lateral skull base malignancy is a rare entity that continues
to challenge cranial base surgeons. Cranial nerve deficits and complication
s are frequent. The success rate of treatment is dependent on histology and
disease extent.