OBJECTIVES: Sinonasal and skull base tumors are rare, making it difficult to identify trends in surgical outcome. This study examines complications in a large cohort of patients undergoing surgery for sinonasal malignancy. METHODS: Following IRB approval, an institutional database was reviewed to identify patients who underwent surgery for sinonasal or skull base malignancies from 1973 to 2016 at our institution. Charlson comorbidity index score and Clavien-Dindo grade were calculated. The main study endpoint was subgroup analysis of Clavien-Dindo Grade 0, Grades 1-2, and Grades 3-5 complications. An ordinal logistic regression model was constructed to assess the association between comorbidities, demographics, tumor characteristics, and surgical complications. RESULTS: In total, 448 patients met inclusion criteria. Perioperative mortality rate at 30 days was 1.6% (n = 7). The rate of severe complications (Clavien-Dindo 3 or higher) was 13.6% (n = 61). Multivariate analysis using an ordinal logistic regression model showed no association between Charlson comorbidity index score and Clavien-Dindo grade of postoperative complication. Advanced T-stage was significantly associated with complications (p = 0.0014; odds ratio: 3.442 [95% confidence interval: 1.615, 7.338]). CONCLUSION: Surgery for sinonasal and skull base tumors is safe with a low mortality rate. Advanced T-stage is associated with postoperative complications. These findings have implications for preoperative risk stratification. Key Points Surgery for sinonasal malignancy is safe with a 30 mortality of 1.6% and rate of severe complications of 12.8%. There is no association between patient comorbidity and post operative complication. On multivariate analysis, only advanced T stage was associated with increased rate of surgical complication.
OBJECTIVES: Sinonasal and skull base tumors are rare, making it difficult to identify trends in surgical outcome. This study examines complications in a large cohort of patients undergoing surgery for sinonasal malignancy. METHODS: Following IRB approval, an institutional database was reviewed to identify patients who underwent surgery for sinonasal or skull base malignancies from 1973 to 2016 at our institution. Charlson comorbidity index score and Clavien-Dindo grade were calculated. The main study endpoint was subgroup analysis of Clavien-Dindo Grade 0, Grades 1-2, and Grades 3-5 complications. An ordinal logistic regression model was constructed to assess the association between comorbidities, demographics, tumor characteristics, and surgical complications. RESULTS: In total, 448 patients met inclusion criteria. Perioperative mortality rate at 30 days was 1.6% (n = 7). The rate of severe complications (Clavien-Dindo 3 or higher) was 13.6% (n = 61). Multivariate analysis using an ordinal logistic regression model showed no association between Charlson comorbidity index score and Clavien-Dindo grade of postoperative complication. Advanced T-stage was significantly associated with complications (p = 0.0014; odds ratio: 3.442 [95% confidence interval: 1.615, 7.338]). CONCLUSION: Surgery for sinonasal and skull base tumors is safe with a low mortality rate. Advanced T-stage is associated with postoperative complications. These findings have implications for preoperative risk stratification. Key Points Surgery for sinonasal malignancy is safe with a 30 mortality of 1.6% and rate of severe complications of 12.8%. There is no association between patient comorbidity and post operative complication. On multivariate analysis, only advanced T stage was associated with increased rate of surgical complication.
Authors: Valerie J Lund; Heinz Stammberger; Piero Nicolai; Paolo Castelnuovo; Tim Beal; Alfred Beham; Manuel Bernal-Sprekelsen; Hannes Braun; Paola Cappabianca; Ricardo Carrau; Luigi Cavallo; George Clarici; Wolfwang Draf; Felice Esposito; Juan Fernandez-Miranda; Wytske Fokkens; Paul Gardner; Verena Gellner; Henrik Hellquist; Phillipe Hermann; Werner Hosemann; David Howard; Nick Jones; Mark Jorissen; Amin Kassam; Daniel Kelly; Senta Kurschel-Lackner; Samuel Leong; Nancy McLaughlin; Roberto Maroldi; Amir Minovi; Michael Mokry; Metin Onerci; Yew Kwang Ong; Daniel Prevedello; Hesham Saleh; Dharambir S Sehti; Daniel Simmen; Carl Snyderman; Auturo Solares; Magaret Spittle; Aldo Stamm; Peter Tomazic; Matteo Trimarchi; Frank Unger; Peter-John Wormald; Adam Zanation Journal: Rhinol Suppl Date: 2010-06-01
Authors: Amin B Kassam; Daniel M Prevedello; Ricardo L Carrau; Carl H Snyderman; Ajith Thomas; Paul Gardner; Adam Zanation; Bulent Duz; S Tonya Stefko; Karin Byers; Michael B Horowitz Journal: J Neurosurg Date: 2010-12-17 Impact factor: 5.115
Authors: Justin D Miller; Robert J Taylor; Emily C Ambrose; Jeffrey P Laux; Charles S Ebert; Adam M Zanation Journal: J Neurol Surg B Skull Base Date: 2016-06-02
Authors: Matthew R Naunheim; Ahmad R Sedaghat; Derrick T Lin; Benjamin S Bleier; Eric H Holbrook; William T Curry; Stacey T Gray Journal: J Neurol Surg B Skull Base Date: 2015-05-15
Authors: Dauren Adilbay; Cristina Valero; Conall Fitzgerald; Avery Yuan; Ximena Mimica; Piyush Gupta; Richard J Wong; Jatin P Shah; Snehal G Patel; Ian Ganly; Marc A Cohen Journal: Head Neck Date: 2022-01-25 Impact factor: 3.147