Transfacial Surgical Approaches to Secure Wide Exposure of the Skull Base

다국어 초록 (Multilingual Abstract)

Background: Treatment of skull base tumors is challenging due to limited access andpresence of important neurovascular structures nearby. The success of a complete tumorresection depends on the extent of tumor exposure and secure field of view. Whilethese tumors are often removed by transcranial endoscopic access, transfacial approachis sometimes required depending on the location and size of the tumor. This study describesvarious transfacial approaches in patients undergoing skull base tumor resection.
Methods: From March to November 2013, 15 patients underwent skull base tumor resectionvia transfacial accesses at a tertiary institution. Data were reviewed for patientdemographics, 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 orbitozygomaticapproach; and seven petroclival-area, pons, cavernous sinus, and lateral-sphenoid-wingtumor patients underwent zygomatic approach. In all cases, the upper and lower marginsof the tumor were visible. Complete tumor removal consisted of 10 cases, and partial tumorremoval in 5. There were no immediate major complications observed for the transfacialportion of the operations. The overall cosmetic results were satisfactory.
Conclusion: Plastic surgeons can use various transfacial approaches according to the locationand size of skull base tumors to secure a sufficient field of view for neurosurgeons.

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