4İ.Ü. İstanbul Tıp Fakültesi Nörolojik Bilimler Nöropatoloji Bölümü, İstanbul OBJECTIVE: For the giant skull base tumors or complex lesions there are some options such as applying the other treatment methods apart from the fundamental surgical treatments, multi-staged cranial base operations or combined cranial base approaches. In this study, we reviewed and discussed our cases performed upon combined approaches.
METHODS: We had surgical resection on 229 patients having skull base lesions between the period of October 1994 and October 2004. 79 of 229 patients had giant tumors and complex lesions. They were operated upon by using combined Skull base approaches. The selected surgical approaches and treatment outcomes were analyzed retrospectively.
RESULTS: Among the cases, 50 of them were tumor cases (38 benign and 12 malign tumors), 18 were basilar apex and anterior communicating artery aneurysm cases, and the other 11 had complex traumatic lesions. The average age of the patients was 47.6 years. In the benign tumor cases except the three patients, the total tumor resection is performed; in 8 cases subtotal resection and in four cases gross total resection were performed in malign tumor cases; all of the aneurysms were clipped, and traumatic lesions were decompressed and repaired dura. The main postoperative early stage (first 30 days) complications included hemiraresis (8 cases), paralysis of the cranial nerves (15 cases), cerebrospinal fluid (CSF) fistulae (5 cases), infections (6 cases), and coma (7 cases). In the early postoperative period seven (%9.8) cases died due to surgical complications
CONCLUSlON: In treatment of giant and complex cranial base lesions, application of combined cranial base is an a1ternative treatment and good results can be obtained with this approaches.
Anahtar Kelimeler : Combined approach, Skullbase, Giant tumor, Complex aneurysm