COMPLICATIONS OF CRANIOFACIAL SURGERY FOR TUMORS INVOLVING THE ANTERIOR CRANIAL BASE

OBJECTIVE: To evaluate the risk factors for postoperative complication s among patients undergoing craniofacial resection for the treatment o f anterior cranial base tumors, a retrospective analysis of patients t reated in University of Tokyo Hospital between September 1987 and Nove mber 1996 was conducted. METHODS: Twenty-nine patients underwent 33 cr aniofacial resections for tumors involving the anterior cranial base. Twenty-three of the 29 patients had malignant tumors and 6 patients ha d benign tumors. Anterior craniofacial resection was performed using a combination of intracranial and extracranial approaches. Radiotherapy and neoadjuvant chemotherapy were administrated to some patients. RES ULTS: Severe intracranial infections were more common among patients w ho underwent partial frontal lobectomies (P < 0.03). These infections occurred only in patients who had been treated previously with a crani otomy (P < 0.02) and a total radiation dose of greater than or equal t o 60 Gy (P = 0.06). Neither management of the extracranial structures nor methods of reconstruction of the cranial base showed significant c orrelation with major postoperative complications. CONCLUSION: Compare d with previous reports, craniofacial resection has become a relativel y safe and effective procedure for the treatment of tumors involving t he anterior cranial base. However, additional care should be taken wit h patients who have experienced a previous craniotomy, frontal lobe in volvement, or radiotherapy with a total dose of greater than or equal to 60 Gy.