Endoscopic Anterior Hemi-Skull Base Resection and Reconstruction

Objectives/Hypothesis: This study aims to validate the efficacy endoscopic anterior hemi-skull base resection and reconstruction.

Methods: A retrospective review of all patients treated for skull base tumors with an endoscopic anterior hemi-skull base resection, preservation of one olfactory nerve, and skull base reconstruction over a 7-year period.

Results: A total of 16 patients were treated from 2008 to 2014, with an endoscopic approach, performing a hemi anterior skull base resection and reconstruction for squamous cell carcinoma (three patients), adenocarcinoma (two patients), esthesioneuroblastoma (two patients), glomangiopericytoma (two patients), mucosal melanoma (two patients), sinonasal low grade sarcoma (one patient), synovial cell sarcoma (one patient), malignant solitary fibrous tumor (one patient), fibrosarcoma (one patient), and Ewing sarcoma (one patient). Duration of follow-up ranged from 4 to 42 months. Overall, two patients had recurrent disease one of them had a local recurrent. Reconstruction was done with a single layer acellular graft in all patients. One patient underwent an additional layer of nasoseptal graft for reconstruction. Postoperative CSF leak reported in two patients. No lumber drain used in any patient. Patients reported lack of smell postoperatively.

Conclusion: Endoscopic hemi anterior skull base resection and reconstruction can achieve a high oncologic success rate on select patients with minimal complications. Subjective smell and taste outcomes, however, is poor.

Level of Evidence: The level of evidence was 4.