Long-term outcomes of anterior skull base surgery

Abstract

The authors review and compare the incidence and severity of complications associated with the traditional craniofacial and the subcranial approaches to anterior skull base surgery. It is shown that the subcranial approach, when appropriately used, is associated with less morbidity and shorter hospital stay. Complication rates have also decreased with the use of free-tissue transfer in select patients. These include patients who have undergone prior bifrontal craniotomy, have received greater than 60 Gy to the anterior skull base, or require extensive skull base resection, including partial or total frontal lobectomy. Recent advances in anterior skull base reconstruction are reviewed. Overall survival rate in patients with anterior skull base malignancies is examined. A review of the recent literature demonstrates disease-free survival rates ranging from 24% to 68%. The authors examine these issues with particular emphasis on quality of life.