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DOI: 10.1055/s-0033-1336324
Ameloblastoma at the Skull Base: A Single-Center Experience Over 25 Years
Objective: Ameloblastomas are odontogenic tumors that, although histologically benign, may exhibit local invasion into the anterior skull base from the maxilla. These tumors are rare, but can cause significant symptomatology through compression of local structures. We present the largest series of skull base ameloblastomas reported in the literature to date.
Methods: Retrospective review of medical records from the University of Virginia Hospital from 1987-2012. All patients undergoing surgery for resection of ameloblastoma with involvement of the anterior or middle cranial fossa or orbit were included. Patient and tumor characteristics, as well as treatment strategy, complications, and outcomes, were recorded and analyzed.
Results: Six patients were included in this series. All were men, and the average age at initial treatment at UVA was 55 years. Lesions were all based in the maxilla and extended into the orbit or retro-orbital skull base. All patients underwent multiple procedures, with GTR achieved in all cases for which this was the intent. Periorbita was resected in three cases. There was one case of epiphora after intraoperative transection of the nasolacrimal duct. Postoperative diplopia secondary to periorbital dissection, requiring tarsorrhaphy, occurred in one case.
Conclusions: Ameloblastoma is a rare, benign tumor that may cause significant morbidity depending on the extent or involvement of the cranial base structures. Due to the high incidence of recurrence, avoidance of periorbital dissection may avoid postoperative diplopia and the need for eye muscle surgery. Gross total resection appears to be associated with longer overall and progression-free survival.