Dural reconstruction with or without a bone graft of paranasal and anterior skullbase malignancies: Retrospective single-center analysis of 11 cases and review of literature

IF 1.9 Q3 CLINICAL NEUROLOGY Brain & spine Pub Date : 2024-01-01 DOI:10.1016/j.bas.2023.102740
Björn Sommer , Ina Konietzko , Maximilian Niklas Bonk , Tina Schaller , Bruno Märkl , Klaus Henning Kahl , Georg Stüben , Johannes Zenk , Ehab Shiban
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引用次数: 0

Abstract

Introduction

The reconstruction of frontobasal defects following oncologic resections of paranasal and anterior skull base (ASB) malignancies remains challenging. Ineffective reconstruction could lead to cerebrospinal fluid leak, meningitis, and tension pneumocephalus.

Research question

Aim of this investigation was to analyse postoperative complication rates with or without bone graft for anterior skull base reconstruction.

Material and methods

In this retrospective study, we included patients following resection of paranasal and/or anterior skull base malignancies between October 2013 and December 2022. Complications were analysed with regards to the type of skull base reconstruction.

Results

Eleven patients were identified (2 female, 9 male, age (median, SD) 64 ± 14.1 years (range 38–81). There were nine cases of paranasal sinus and nasal cavity carcinomas and two cases of olfactory neuroblastomas. Overall survival was 22.5 ± 28 months (range: 5–78), progression free survival was 17.0 ± 20.3 months (range: 11–78). Bone skull base reconstruction using a split graft was performed in three cases. Postoperative complications requiring surgical intervention were seen in 33% (one tension pneumocephalus) of cases in the bone reconstruction group and 50% (three patients with cerebrospinal fluid leak, one infection) in the non-bone reconstruction group.

Discussion and conclusion

The structural reinforcement of structural bone chip grafting might provide additional support of the ASB and prevent CSF leakage or encephalocele. Especially in large (>10 cm2) bone defects of advanced sinonasal malignancies extending into the middle cranial fossa, the full armamentarium of reconstruction possibilities should be considered.

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鼻旁和前颅底恶性肿瘤硬脑膜重建与否的骨移植:对11个病例的单中心回顾性分析和文献综述
导言鼻旁和前颅底(ASB)恶性肿瘤切除术后的前颅底缺损重建仍具有挑战性。材料和方法在这项回顾性研究中,我们纳入了 2013 年 10 月至 2022 年 12 月间接受副鼻腔和/或前颅底恶性肿瘤切除术的患者。结果共发现 7 名患者(2 名女性,9 名男性,年龄(中位数,标码)64 ± 14.1 岁(38-81 岁)。其中9例为鼻旁窦和鼻腔癌,2例为嗅觉神经母细胞瘤。总生存期为(22.5±28)个月(范围:5-78),无进展生存期为(17.0±20.3)个月(范围:11-78)。三例患者使用劈裂移植进行了骨颅底重建。术后需要手术干预的并发症在骨重建组中占 33%(1 例张力性气胸),在非骨重建组中占 50%(3 例脑脊液漏患者,1 例感染)。特别是对于延伸至中颅窝的晚期鼻窦鼻腔恶性肿瘤的大面积(10 平方厘米)骨缺损,应全面考虑重建的可能性。
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来源期刊
Brain & spine
Brain & spine Surgery
CiteScore
1.10
自引率
0.00%
发文量
0
审稿时长
71 days
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