Journal article
Combined approaches to the skull base for intracranial extension of tumors via perineural spread can improve patient outcomes
Clinical neurology and neurosurgery, Vol.150, pp.46-53
11/01/2016
DOI: 10.1016/j.clineuro.2016.08.029
PMID: 27588370
Abstract
•Perineural tumor spread in head and neck carcinoma represents a poor prognosis.•Surgery for perineural spread can markedly improve symptoms and quality of life.•Aggressive and combined approaches can improve both morbidity and mortality.
Many neoplasms of the head and neck extend centripetally, gaining access to the central nervous system via nerves through the skull base foramina. Often patients with perineural spread have been excluded from aggressive interventions given the overall poor prognosis and technical difficulty when addressing the perineural components. However, in carefully selected patients combined surgical approaches can provide the greatest potential for disease control as well as neural decompression for symptom relief. We performed a retrospective chart review of 20 consecutive patients who underwent skull base approaches for resection of tumors with intracranial extension via perineural spread from 2011 to 2014. Patients were evaluated for symptom change, surgical approaches, histopathology, adjuvant therapy, outcome, and prognosis. The most common presenting symptoms were pain or cranial nerve palsies. 55% of patients underwent endoscopic endonasal approaches, 50% transcranial approaches, and 15% underwent transfacial approaches. Overall 85% of patients reported symptom improvement in the post-operative period while 40% were completely asymptomatic following surgical resection. Ultimately, we observed a 45% mortality rate with an average survival of 8 months after diagnosis. In carefully selected patients, an aggressive multidisciplinary approach using a combination of surgical avenues to the skull base for the treatment of intracranial tumor via perineural extension can improve patient quality of life.
Details
- Title: Subtitle
- Combined approaches to the skull base for intracranial extension of tumors via perineural spread can improve patient outcomes
- Creators
- Sheri K. Palejwala - University of ArizonaJonnae Y. Barry - University of ArizonaCrystal N. Rodriguez - University of ArizonaChandni A. Parikh - University of ArizonaStephen A. Goldstein - University of ArizonaG. Michael Lemole - University of Arizona
- Resource Type
- Journal article
- Publication Details
- Clinical neurology and neurosurgery, Vol.150, pp.46-53
- Publisher
- Elsevier B.V
- DOI
- 10.1016/j.clineuro.2016.08.029
- PMID
- 27588370
- ISSN
- 0303-8467
- eISSN
- 1872-6968
- Number of pages
- 8
- Language
- English
- Date published
- 11/01/2016
- Academic Unit
- Surgery
- Record Identifier
- 9984701749602771
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