Management of the cavernous sinus in en bloc resections of malignant skullbase tumors

Citation
K. Saito et al., Management of the cavernous sinus in en bloc resections of malignant skullbase tumors, HEAD NECK, 21(8), 1999, pp. 734-742
Citations number
21
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Otolaryngology
Journal title
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
ISSN journal
1043-3074 → ACNP
Volume
21
Issue
8
Year of publication
1999
Pages
734 - 742
Database
ISI
SICI code
1043-3074(199912)21:8<734:MOTCSI>2.0.ZU;2-3
Abstract
Background. Cavernous sinus involvement represents the most difficult probl em in en bloc resection of malignant skull base tumors. We developed three types of surgical procedures for manipulating the cavernous sinus to achiev e en bloc resection of these tumors. Methods. In a type 1 procedure, the cavemous sinus was dissected epidurally and retracted posteriorly. In a type 2 procedure, the anterolateral portio n of the cavernous sinus was excised and the carotid artery preserved. In a type 3 procedure, the entire cavernous sinus including the carotid artery was resected. Results. Of 25 malignant skull base tumors, type 1 procedures were used in 7, type 2 in 5, and type 3 in 3. For these 15 patients, 7 are in good condi tion without evidence of tumor recurrence, 2 are alive with tumor, 4 died o f tumor recurrence, and 2 died of complications. Two-year survival rates we re 54% for patients with a type 1 procedure, 100% for type 2, and 33% for t ype 3. Conclusions. Using our techniques, we could totally excise tumors impinging on the cavernous sinus. However, the advanced tumors requiring resection o f the entire cavernous sinus with the carotid artery are associated with ma jor morbidity and mortality. (C) 1999 John Wiley & Sons, Inc. Head Neck 21: 734-742, 1999.