The Impact of Multidisciplinary Skull Base Conference on Patient Assessment and Management in Skull Base Surgery

Background: Skull base surgery is a dynamic subspecialty that requires effective collaboration between multiple disciplines including neurosurgery, neurotology, rhinology, head and neck surgery, ophthalmology, radiation oncology, medical oncology, and endocrinology. Although numerous studies have assessed the impact of multidisciplinary conferences on patient assessment, management, and outcomes in various oncologic settings, there is a paucity of literature regarding the impact of multidisciplinary conference on the treatment of patients with skull base pathology. Therefore, we aim to review our institutional multidisciplinary skull base conference experience and evaluate the impact of a dedicated multidisciplinary conference on the assessment and management of patients with skull base pathology.

Methods: One thousand thirty-eight consecutive case presentations, comprised of 836 patients, discussed at a formal weekly multidisciplinary skull base conference between January 2013 and August 2016 were reviewed retrospectively. The various skull base pathologies presented were analyzed. Alterations in radiologic, clinical, and surgical interpretations were reviewed and the impact of these alterations on patient assessment, including recommendations for additional studies, and consensus management recommendations were examined. The rate of cross-referral between disciplines was also assessed.

Conclusion: Formal multidisciplinary case review frequently led to alterations in interpretation of clinical data and provided guidance for patient assessment and management practices, including surgical planning. Although further studies are needed to assess the impact of multidisciplinary skull base conference on patient outcomes, a multidisciplinary conference provides an invaluable educational resource for an academic institution and is an excellent forum to optimize the collaboration between multiple disciplines required in effective management of patients with skull base pathology.