Interdisciplinary surgical therapy of tumors of the frontal skull base

Most tumors of the anterior cranial base invade both the intra- and extracranial regions at the borderline of the cranial and facial skeleton. In surgical treatment of these lesions, combined craniofacial approaches are applied in accordance with the anatomical conditions. Surgery is performed by an interdisciplinary team of neurosurgeons and maxillofacial surgeons. To evaluate the effectiveness and the complications of this surgical concept, the data of 58 patients treated over a 10-year period were collected. In these patients, 60 operations were performed, including two operations for tumor recurrence. In 38 cases, complete tumor removal was achieved. One patient died in the early postoperative period because of pulmonary embolism. Significant neurological deficits occurred in three patients. In most cases, postoperative complications and functional disability were both due to intradural invasion of the tumor. Nevertheless, in the majority of the cases radical tumor removal is achieved with acceptable morbidity when microsurgical techniques are applied for the resection of the intradural tumor. Both the meticulous repair of dural defects and the reconstruction of the anterior cranial base and orbit contribute distinctly to a reduction in the rate of postoperative complications and to acceptable cosmetic results.