Resection of invasive head and neck neoplasms involving skull base
To investigate the operative methods of invasive head and neck neoplasms involving skull base. Thirty-two cases with invasive head and neck neoplasms involving anterior and lateral skull base, from 1997 to 2005, were treated with surgical resection. Nine surgical approaches including endoscopic transnasal approach for five cases, combined craniofacial approach for three cases, maxillary resection approach for 15 cases, transpalatal approach for one case, transmandibular approach for one case, lateral neck-mandibular incision approach for two cases, combined retroauricular and neck approach for one case, frontotemporal approach for two cases, and facial translocation approach for two cases were used to resect the tumors. Four cases with nasal sinus mucocele were only applied drainage and one case with chordoma was subtotally resected. The tumors of the rest 27 cases were totally removed. Although one case complicated with cerebrospinal fluid leak and recovered within one week, no one died from the operation and no serious cranium-cerebrum complication occurred. Eight cases with benign tumor were followed up for six months to eight years without recurrence and no one died. For 24 cases with malignant tumor, survival rates of three and five years were 63.2% (12/19), 41.7% (5/12) respectively. Surgical approach must be designed according to the pathological change's characters, site and invasive range. Favorable curative effect could be achieved by resecting tumors totally as possible, protecting important constitutions, and adopting proper reparative techniques.