Clinical Analysis Of Efficacy Of The Frontal Mid-line Incision With The Nasal Pyramid Over-turned Downward And Endoscopic Surgery In The Front Of The Skull Base Tumor Resection

Objective: To study the surgical approach for the resection of tumors in the anterior skull base and to introduce an approach of the frontal mid-line incision with the nasal pyramid over-turned downward and Endoscopic surgery.The goal of this study was to compare the outcome for these two approachesMethod: Retrospective chart analysis was conducted to identify patients undergoing resection of ASB tumors between January 2007 and January 2013. Demographic data,tumor characteristics, and the surgical approach used were determined.The mean operative time, estimated blood loss, hospital stay,and complications were analyzed.Recurrence and mortality rates were calculated.Results: Nine patients were managed with the MIER approach, and 16 patients were treated with the traditional open approach. No significant difference was observed between groups on operative time, estimated blood loss, or hospital stay. Major complications were encountered in 2/9(22%) and 7/16(44%) patients in the frontal mid-line incision with the nasal pyramid over-turned downward and MIER groups,respectively. Recurrence was observed in 3/9(33%) and 5/14(36%) of the patients in the frontal mid-line incision with the nasal pyramid over-turned downward and MIER groups, respectively. Mortality rates in the frontal mid-line incision with the nasal pyramid over-turned downward and MIER groups were 1/9(11%)and 2/16(13%),respectively.Conclusion: In this preliminary study, MIER of ASB neoplasia did not differ significantly from the frontal mid-line incision with the nasal pyramid over-turneddownward in operative time, estimated blood loss, hospital stay, or complication rate.Survival and recurrence rates were similar also. This early experience suggests that MIER is a viable alternative for the surgical management of ASB lesions in appropriately selected patients. Choice of surgical approach should be conducive to tumor resection as possible and reduce the recurrence rate and mortality, for both the choice of surgical approach depends on the surgeon for both surgical proficiency as well as the patient’s specific circumstances.