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Skull base bony lesions: Management nuances; a retrospective analysis from a Tertiary Care Centre
BACKGROUND: Skull base lesions are not uncommon, but their management has been challenging for surgeons. There is large no of bony tumors at the skull base which has not been studied in detail as a group. These tumors are difficult not only because of their location but also due to their variability...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5532939/ https://www.ncbi.nlm.nih.gov/pubmed/28761532 http://dx.doi.org/10.4103/1793-5482.185068 |
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author | Singh, Amit Kumar Srivastava, Arun Kumar Sardhara, Jayesh Bhaisora, Kamlesh Singh Das, Kuntal Kanti Mehrotra, Anant Sahu, Rabi Narayan Jaiswal, Awadhesh Kumar Behari, Sanjay |
author_facet | Singh, Amit Kumar Srivastava, Arun Kumar Sardhara, Jayesh Bhaisora, Kamlesh Singh Das, Kuntal Kanti Mehrotra, Anant Sahu, Rabi Narayan Jaiswal, Awadhesh Kumar Behari, Sanjay |
author_sort | Singh, Amit Kumar |
collection | PubMed |
description | BACKGROUND: Skull base lesions are not uncommon, but their management has been challenging for surgeons. There is large no of bony tumors at the skull base which has not been studied in detail as a group. These tumors are difficult not only because of their location but also due to their variability in the involvement of important local structure. Through this retrospective analysis from a Tertiary Care Centre, we are summarizing the details of skull base bony lesions and its management nuances. MATERIALS AND METHODS: The histopathologically, radiologically, and surgically proven cases of skull base bony tumors or lesions involving bone were analyzed from the neurosurgery, neuropathology record of our Tertiary Care Institute from January 2009 to January 2014. All available preoperative and postoperative details were noted from their case files. The extent of excision was ascertained from operation records and postoperative magnetic resonance imaging if available. RESULTS: We have surgically managed 41 cases of skull base bony tumors. It includes 11 patients of anterior skull base, 13 middle skull base, and 17 posterior skull base bony tumors. The most common bony tumor was chordoma 15 (36.6%), followed by fibrous dysplasia 5 (12.2%), chondrosarcoma (12.2%), and ewings sarcoma-peripheral primitive neuroectodermal tumor (EWS-pPNET) five cases (12.2%) each. There were more malignant lesions (n = 29, 70.7%) at skull base than benign (n = 12, 29.3%) lesions. The surgical approach employed depended on location of tumor and pathology. Total mortality was 8 (20%) of whom 5 patients were of histological proven EWS-pPNET. CONCLUSIONS: Bony skull base lesion consists of wide variety of lesions, and requires multispecialty management. The complex lesions required tailored approaches surgery of these lesions. With the advent of microsurgical and endoscopic techniques, and use of navigation better outcomes are being seen, but these lesions require further study for development of proper management plan. |
format | Online Article Text |
id | pubmed-5532939 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-55329392017-07-31 Skull base bony lesions: Management nuances; a retrospective analysis from a Tertiary Care Centre Singh, Amit Kumar Srivastava, Arun Kumar Sardhara, Jayesh Bhaisora, Kamlesh Singh Das, Kuntal Kanti Mehrotra, Anant Sahu, Rabi Narayan Jaiswal, Awadhesh Kumar Behari, Sanjay Asian J Neurosurg Original Article BACKGROUND: Skull base lesions are not uncommon, but their management has been challenging for surgeons. There is large no of bony tumors at the skull base which has not been studied in detail as a group. These tumors are difficult not only because of their location but also due to their variability in the involvement of important local structure. Through this retrospective analysis from a Tertiary Care Centre, we are summarizing the details of skull base bony lesions and its management nuances. MATERIALS AND METHODS: The histopathologically, radiologically, and surgically proven cases of skull base bony tumors or lesions involving bone were analyzed from the neurosurgery, neuropathology record of our Tertiary Care Institute from January 2009 to January 2014. All available preoperative and postoperative details were noted from their case files. The extent of excision was ascertained from operation records and postoperative magnetic resonance imaging if available. RESULTS: We have surgically managed 41 cases of skull base bony tumors. It includes 11 patients of anterior skull base, 13 middle skull base, and 17 posterior skull base bony tumors. The most common bony tumor was chordoma 15 (36.6%), followed by fibrous dysplasia 5 (12.2%), chondrosarcoma (12.2%), and ewings sarcoma-peripheral primitive neuroectodermal tumor (EWS-pPNET) five cases (12.2%) each. There were more malignant lesions (n = 29, 70.7%) at skull base than benign (n = 12, 29.3%) lesions. The surgical approach employed depended on location of tumor and pathology. Total mortality was 8 (20%) of whom 5 patients were of histological proven EWS-pPNET. CONCLUSIONS: Bony skull base lesion consists of wide variety of lesions, and requires multispecialty management. The complex lesions required tailored approaches surgery of these lesions. With the advent of microsurgical and endoscopic techniques, and use of navigation better outcomes are being seen, but these lesions require further study for development of proper management plan. Medknow Publications & Media Pvt Ltd 2017 /pmc/articles/PMC5532939/ /pubmed/28761532 http://dx.doi.org/10.4103/1793-5482.185068 Text en Copyright: © 2016 Asian Journal of Neurosurgery http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Singh, Amit Kumar Srivastava, Arun Kumar Sardhara, Jayesh Bhaisora, Kamlesh Singh Das, Kuntal Kanti Mehrotra, Anant Sahu, Rabi Narayan Jaiswal, Awadhesh Kumar Behari, Sanjay Skull base bony lesions: Management nuances; a retrospective analysis from a Tertiary Care Centre |
title | Skull base bony lesions: Management nuances; a retrospective analysis from a Tertiary Care Centre |
title_full | Skull base bony lesions: Management nuances; a retrospective analysis from a Tertiary Care Centre |
title_fullStr | Skull base bony lesions: Management nuances; a retrospective analysis from a Tertiary Care Centre |
title_full_unstemmed | Skull base bony lesions: Management nuances; a retrospective analysis from a Tertiary Care Centre |
title_short | Skull base bony lesions: Management nuances; a retrospective analysis from a Tertiary Care Centre |
title_sort | skull base bony lesions: management nuances; a retrospective analysis from a tertiary care centre |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5532939/ https://www.ncbi.nlm.nih.gov/pubmed/28761532 http://dx.doi.org/10.4103/1793-5482.185068 |
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