Diagnosis and surgical management of bone tumors involving the skull base

• Main Authors: Fu⁃xing ZUO, Ang⁃si LIU, Ke HU, Jian⁃xin KONG, Xue⁃ji LI, Ming FENG, Jing⁃hai WAN
• Format: Article
• Language: English
• Published: Tianjin Huanhu Hospital 2020-03-01
• Series: Chinese Journal of Contemporary Neurology and Neurosurgery
• Subjects: skull base neoplasms; neoplasms, bone tissue; precision medicine; neurosurgical procedures
• Online Access: http://www.cjcnn.org/index.php/cjcnn/article/view/2099

Objective To review experience of diagnosis, surgical procedures and comprehensive therapeutic strategies for skull base bone tumors. Methods and Results Clinical data of 76 patients with skull base bone tumors were retrospectively analyzed from September 2006 to March 2018. After preoperative assessment, different kinds of surgical approaches including endonasal, intraoral, maxillary swing, craniocervical transjugular, Derome, frontotemporal and infratemporal approaches were chosen according to clinical and radiographic findings. In comparison with 24 patients receiving the endoscopic surgery, other 52 patients were operated on under microscopic visualization. Total resection was achieved in 38 cases, and 22 patients underwent subtotal resection. In addition, 14 cases received partial resection while biopsies were performed in 2 cases to confirm histological findings. Tumor pathology included chordoma (28 cases), osteosarcoma (19 cases), chondrosarcoma (11 cases), fibrous dysplasia (8 cases), giant cell tumor of bone (5 cases), osteoblastoma (3 cases), osteochondroma (1 case), and chondromyxiod fibroma (1 case). Complications included cranial nerve deficits (19 cases), hemiparesis (3 cases), cerebrospinal fluid leakage (12 cases), intracranial infection (8 cases), pneumonitis (4 cases), and wound dehiscence (4 cases). During a 20 to 158 months follow ⁃ up, 11 cases were lost and 21 patients died in the study period. The disease ⁃ free survival was achieved in 34 cases while 10 patients experienced tumor progression. Conclusions Malignant bone tumors invading the skull base is much more common comparing with the benign lesions. Multidisciplinary consultation may improve diagnostic reliability and clarify the therapeutic purpose. Radical resection using the individualized approaches accompanied by comprehensive therapy should be considered to improve the outcomes of patients. DOI：10.3969/j.issn.1672⁃6731.2020.03.007