Clinical Analysis Of Combined Surgery In Removing Communicative Tumors Invading Anterior Or Middle Skull Base

The skull base is affected by a wide range of tumor pathologies,and communicative tumor is a special type of skull base tumors.They are often located in critical areas within the cranium that are especially hard to reach with routine surgical techniques.Involvement of cranial nerves and vessels makes these lesions particularly challenging to treat surgically.Finding an optimal surgery approach for complete surgical removal accompanyed by the least normal tissue injury is very important to reduce surgery complications and guarantee patients good lives.Objective:To analyse surgical approaches in removing kinds of communicative tumors invading anterior or middle skull base in order to find the optimal surgical approach.Methods:We retrospectively analyzed 47 patients who came from Qilu hospital from the year 1998 to 2008 with communicative tumors invading anterior or middle skull base.Of the 21 patients with communicative tumors invading anterior skull base,we adopted transbasal approach combined with nasofacial resection(13),one-side transbasal approach combined with nasal resection(5),extended anterior skull base approach(3);extended pterional approach for 5 patients with cranio-orbital communicative tumors,2 of them underwent supraorbital resection simultaneously;oronasosphenoidal approach for 3 patients with saddle-nasal communicative tumors;of the 18 patients with communicative tumors invading middle skull base,we adopted pterional approach combined with Weber-Fergusson(12),and infratemporal approach(6).Results:Complete tumor removal 31,massive tumor removal 16,none surgery death.Within 5-36 months follow up,complete recovery 29,obviously ameliorated effect 14,unobvious effect 4.As for the patients with malignant tumors,1 death in 6 months,2 survivals aider 1 year,5 survivals after 2 years,3 survivals after 3 years,3 information lost.Conclusions:Communicative skull base tumors are often tightly involved with nerves and vessels,and skull base surgery tends to be complicated.We should choose suitable surgery approach taking into account nature,situation,size of the tumors,and the involvement with nerves and vessels around tumors.