Anatomical classification and surgical management of communicating tumors invading the anterior or middle skull base

Abstract

Objective To study the anatomical classification and surgical management of communicating tumors invading the anterior or middle skull base. Methods According to the location and growth direction of the tumors, the communicating tumors invading the anterior or middle skull base in 29 patients were classified into 4 types, namely fronto-naso-orbital tumors in 16 cases, middle-lateral cranial base tumors in 8 cases, central-medial skull base tumors in 4 cases and petrous bone-jugular foramen tumor in 1 case. Based on this classification, extended transbasal approach (13 cases), supraorbital-pterional approach (9 cases), fronto-temporal approach (3 cases), ffontotemporal-orbitozygomatic approach (3 cases) and transpetrol approach (1 case) were adopted for tumor resection and skull base defect reconstruction. In the transbasal approach group, the surgery was performed also through transnasal endoscopic approaches. Results Twenty-four patients underwent total tumor resection and 5 had subtotal tumor resection. No operative death or serious complications (e.g. intracranial infection, cerebrospinal fluid leakage or meningoencephalocele) occurred after the operations. Conclusion Classification of the communicating tumors invading the anterior or middle skull base according to their location and growth direction facilitates planning of the surgical approaches for tumor resection and skull base defect reconstruction. Key words: base tumor; Microsurgery; Skull base reconstruction