Complications of Skull Base Surgery

Abstract

There is a tremendous potential for a devastating patient outcome from skull base surgery. The combination of a prolonged and complex anesthetic; a tumor resection involving head and neck; neurosurgical, neurotologic, and vascular surgeons; and the need for a complex reconstruction leads to an almost geometric progression of potential complications. Added to the potential for treatment-related complications is the preexistent psychologic stress, underlying medical disease, and the ravage of prior therapy. The frequency of difficulty experienced by the patient undergoing skull base surgery can be exemplified by the question asked by an excellent neurosurgeon after being involved with three or four combined resections: "Are all skull base cases so complicated?" An outcome analysis of 130 consecutive patients of mine has given credence to this question. In fact, virtually all patients undergoing skull base surgery have some alteration in cosmetic, physiologic, or functional status because of the expected sequelae or untoward complications related to skull base surgery.