Abstract：
: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.
journal_name
Clin Neurol Neurosurgjournal_title
Clinical neurology and neurosurgeryauthors
Palejwala SK,Barry JY,Rodriguez CN,Parikh CA,Goldstein SA,Lemole GM Jrdoi
10.1016/j.clineuro.2016.08.029subject
Has Abstractpub_date
2016-11-01 00:00:00pages
46-53eissn
0303-8467issn
1872-6968pii
S0303-8467(16)30326-2journal_volume
150pub_type
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
pub_type： 杂志文章,随机对照试验
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更新日期：2006-09-01 00:00:00
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pub_type： 杂志文章,评审
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
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journal_title：Clinical neurology and neurosurgery
pub_type： 杂志文章
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