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Complications of craniofacial resection for malignant tumors of the skull base: Report of an International Collaborative Study
Author(s) -
Ganly Ian,
Patel Snehal G.,
Singh Bhuvanesh,
Kraus Dennis H.,
Bridger Patrick G.,
Cantu Giulo,
Cheesman Anthony,
De Sa Geraldo,
Donald Paul,
Fliss Dan,
Gullane Patrick,
Janecka Ivo,
Kamata Shinetsu,
Kowalski Luiz P.,
Levine Paul,
Medina Luiz R.,
Pradhan Sultan,
Schramm Victor,
Snyderman Carl,
Wei William I.,
Shah Jatin P.
Publication year - 2005
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20166
Subject(s) - medicine , comorbidity , craniofacial , perioperative , surgery , cohort , complication , radiation therapy , skull , neurosurgery , mortality rate , psychiatry
Background. Advances in imaging, surgical technique, and perioperative care have made craniofacial resection (CFR) an effective and safe option for treating malignant tumors involving the skull base. The procedure does, however, have complications. Because of the relative rarity of these tumors, most existing data on postoperative complications come from individual reports of relatively small series of patients. This international collaborative report examines a large cohort of patients accumulated from multiple institutions with the aim of identifying patient‐related and tumor‐related predictors of postoperative morbidity and mortality and set a benchmark for future studies. Methods. One thousand one hundred ninety‐three patients from 17 institutions were analyzed for postoperative mortality and complications. Postoperative complications were classified into systemic, wound, central nervous system (CNS), and orbit. Statistical analyses were carried out in relation to patient characteristics, extent of disease, prior radiation treatment, and type of reconstruction to determine factors that predicted mortality or complications. Results. Postoperative mortality occurred in 56 patients (4.7%). The presence of medical comorbidity was the only independent predictor of mortality. Postoperative complications occurred in 433 patients (36.3%). Wound complications occurred in 237 (19.8%), CNS‐related complications in 193 (16.2%), orbital complications in 20 (1.7%), and systemic complications in 57 (4.8%) patients. Medical comorbidity, prior radiation therapy, and the extent of intracranial tumour involvement were independent predictors of postoperative complications. Conclusions. CFR is a safe surgical treatment for malignant tumors of the skull base, with an overall mortality of 4.7% and complication rate of 36.3%. The impact of medical comorbidity and intracranial tumor extent should be carefully considered when planning therapy for patients whose tumors are amenable to CFR. © 2005 Wiley Periodicals, Inc. Head Neck 27: XXX–XXX, 2005