Craniofacial resections for tumors involving the base of the skull.

Over a 10 year period, 42 patients with tumors involving the base of the skull underwent operation at our institution. Twenty-six patients had tumors involving the anterior fossa and cribriform plate, 3 patients had tumors involving the anterior fossa and orbit, 3 patients had invasion of the middle fossa, 5 patients had invasion of the temporal bone, and 5 patients had invasion of the clivus. A detailed analysis of the 26 patients who underwent craniofacial resection for tumors invading the anterior fossa cribriform plate region has been presented. Histologic studies revealed epithelial tumors in 18 patients, sarcoma in 6 patients, melanoma in one patient, and ossifying fibroma in one patient. The median survival in this group of patients was 60 months. Survival was influenced by histologic diagnosis. Malignant tumors involving the base of the skull can be successfully resected using a craniofacial approach with minimum morbidity and acceptable operative mortality as demonstrated in this experience. Unfavorable prognostic factors included massive intracranial extension, high grade tumor, and previous treatment failure.