Complications of skull base surgery: an analysis of 30 cases.

OBJECTIVES: To evaluate the risk factors for perioperative complications among patients undergoing craniofacial resection for the treatment of skull base tumors.

DESIGN: Retrospective analysis.

PARTICIPANTS: The study group comprised 29 patients with skull base tumors (22 malignant and 7 benign) who underwent 30 craniofacial resections at Hokkaido University Hospital between 1989 and 2006. Of these cases, 21 had undergone prior treatment by radiation (16 cases), surgery (7 cases), or chemotherapy (1 case). Moreover, 19 needed extended resection involving the dura (11 cases), brain (5 cases), orbit (12 cases), hard palate (5 cases), skin (3 cases), or cavernous sinus (2 cases).

MAIN OUTCOME MEASURES: Perioperative complications and risk factor associated with their incidence.

RESULTS: Perioperative complications occurred in 12 patients (40%; 13 cases). There was a significant difference between complication rates for cases with and without prior therapy (52.4% vs. 11.1%). The complication rate for dural resection cases was 81.8%. There was a significant difference between complication rates for cases with and without dura resection. No postoperative mortality was reported.

CONCLUSIONS: Craniofacial resection is a safe and effective treatment for skull base tumors. However, additional care is required in patients with extended resection (especially dural) and those who have undergone prior therapy.