Craniofacial Approaches to Complex Skull Base Tumors

Skull base tumors include a great variety of lesions which may not have a favorable outcome for patients from the medical and social point of view. According to pathology and the anatomic involvement of the tumor a multidisciplinary team may be required to offer a better prognosis to the patient. These cases represent a challenge to the medical team and to the patient. We present a series of cases managed in the newly formed Skull Base Tumor Clinic at our institution which have been managed by a multidisciplinary team formed by neurosurgery, ENT, maxilofacial surgery, oncology and radio oncology. The series includes the management of 7 complex tumors that involve different compartments of the skull base and craneofacial region. The most frecuent pathology is sarcoma (4), ameloblastoma (1), giant cell granuloma (1) and a giant nasoangiofibroma (1). The cases required 5 Lefort, 3 transcigomatic transcondilar, 3 pretemporal and 1 transbasal approaches. Morbimortality of the series is 0%. These cases represent team work to have the best result possible considering radical resection, adecuate postop reconstruction and oncologic follow up. The goal of presenting this work is to share the acquired experience in the management of complex skull base tumors by a multidisciplinary team.