Physical morbidity by surgical approach and tumor location in skull base surgery

• Published in: Head & neck 2013-04, Vol.35 (4), p.493-499
• Main Authors: de Almeida, John R., Witterick, Ian J., Gullane, Patrick J., Gentili, Fred, Lohfeld, Lynne, Ringash, Jolie, Thoma, Achilles, Vescan, Allan D.
• Format: Article
• Language: English
• Subjects: Adult; Aged; endoscopic; Endoscopy - adverse effects; Endoscopy - methods; Female; functional outcomes; Humans; Male; Middle Aged; Morbidity; Neurosurgical Procedures - adverse effects; Neurosurgical Procedures - methods; physical morbidity; Postoperative Complications - epidemiology; Retrospective Studies; Skull Base - pathology; Skull Base - surgery; Skull Base Neoplasms - diagnosis; Skull Base Neoplasms - pathology; Skull Base Neoplasms - surgery
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.23006

Background Skull base tumors are associated with physical symptoms that vary depending on location and surgical approach. Methods Skull base surgery patients (n = 138) were retrospectively reviewed and physical symptoms were quantified. Patients were divided into 4 groups by surgical approach (open, endoscopic) and tumor location (anterior, central). Multivariate analyses determined odds for symptom development. Results Patients with anterior lesions presented with more nasal symptoms compared to those with central lesions (63% vs 6.8%; p < .001). Those with central lesions presented with more neurologic (41.1% vs 12.3%; p < .001) and endocrine symptoms (19.2% vs 0%; p < .001). Three of 4 groups experienced a reduction in neurologic and visual symptoms after surgery. One group (endoscopic/central) experienced a reduction in endocrine and an increase in nasal symptoms. Anterior tumors (p = .02) and endoscopic approaches (p = .002) predicted increased nasal morbidity. Conclusion Physical morbidity from skull base tumors may vary based on tumor location and surgical approach. © 2012 Wiley Periodicals, Inc. Head Neck, 2013