Archives of Craniofacial Surgery (대한두개안면성형외과학회지)

Korean Cleft Palate-Craniofacial Association (대한두개안면성형외과학회)
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Transfacial Surgical Approaches to Secure Wide Exposure of the Skull Base

  • Kim, Sin Rak (Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine) ;
  • Lee, Jung Woo (Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine) ;
  • Han, Yea Sik (Department of Plastic and Reconstructive Surgery, Kosin University College of Medicine) ;
  • Kim, Han Kyu (Department of Neurosurgery, Bundang Jesaeng General Hospital)
  • Received : 2014.12.08
  • Accepted : 2015.04.02
  • Published : 2015.04.09
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Abstract

Background: Treatment of skull base tumors is challenging due to limited access and presence of important neurovascular structures nearby. The success of a complete tumor resection depends on the extent of tumor exposure and secure field of view. While these tumors are often removed by transcranial endoscopic access, transfacial approach is sometimes required depending on the location and size of the tumor. This study describes various transfacial approaches in patients undergoing skull base tumor resection. Methods: From March to November 2013, 15 patients underwent skull base tumor resection via transfacial accesses at a tertiary institution. Data were reviewed for patient demographics, type of access used, completeness of tumor resection, surgical outcome, and postoperative complications. Results: Two clivus tumor patients underwent transmaxillary approach; three tuberculum-sellae and suprasellar-hypothalamus tumor patients underwent transbasal approach; three clinoid and retrobulbar intraconal orbital tumor patients underwent orbitozygomatic approach; and seven petroclival-area, pons, cavernous sinus, and lateral-sphenoid-wing tumor patients underwent zygomatic approach. In all cases, the upper and lower margins of the tumor were visible. Complete tumor removal consisted of 10 cases, and partial tumor removal in 5. There were no immediate major complications observed for the transfacial portion of the operations. The overall cosmetic results were satisfactory. Conclusion: Plastic surgeons can use various transfacial approaches according to the location and size of skull base tumors to secure a sufficient field of view for neurosurgeons.

Keywords

References

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