Multidisciplinary system for comprehensive evaluation and. Combined treatment for tumours of the base of the skull. The skull base area separates the base of the brain from the skull. Approximately half of the tumors involved the skull base, and 106 tumors 68% were benign.
The 5year local control rate for benign tumors was 89%. Although skull base surgical approaches are also used for vascular disease, congenital anomalies, and some nonneoplastic bony disorders, this section focuses on neoplastic disease. Mesenchymal tumors of the skull base with particular. The symptoms of most skull base tumors typically appear only after the tumor has grown, causing pressure on vital structures in the brain such as the pituitary gland, the optic nerve and the carotid arteries. They arise from the cranial base or reach it, either from an intracranial or extracranial origin. Most of the skull base tumors treated by oral and maxillofacial surgery mainly involve the lateral skull base lsb. Skull base tumor program md anderson cancer center. What are the presenting features of malignant skull base tumor. Meningiomas are the most common primary skull base tumors. Altschul leads svin discussion on new stroke treatments dr. Infratemporal fossa approach for extensive tumors of the temporal bone and base of the skull. Tumors of the base of skull differential diagnosis. They have the potential to spread to other areas of the body.
Comprehensive management of skull base tumors 20081124 on. General principles 1 surgical anatomy of the cranial base. Comprehensive management of skull base tumors books description the management of tumors in and adjacent to the skullbase is challenging given the complex and critically important anatomy of the region and the wide diversity of tumor pathologies that may be encountered. Nine patients with mesenchymal tumors of the skull base have undergone radical tumor excision by the use of the infratemporal fossa approach. Goals of the ucsf minimally invasive skull base surgery center. Minimally invasive skull base surgery center otolaryngology. Combined treatment for tumours of the base of the skull romuald krajewski 1, andrzej kawecki 1, andrzej kukwa 2 1 head and neck cancer department, cancer centre, warsaw, poland 2 otolaryngology department, division of dentistry, medical university of warsaw, warsaw, poland summary aim tumours situated in the region of the base of the skull are at the limits of possibility for radical re. Between 1989 and 1997 at the university of florida, shafron et al 11 described 70 patients with 76 benign meningiomas treated with linear acceleratorbased radiosurgery. Skull base tumors mikhail chernov and franco demonte skull base tumors arise from the cranial base or reach it, either from an intracranial or extracranial origin. Pdf malignant tumors of the skull base represent a group of diverse and infrequent lesions. United kingdom national multidisciplinary guidelines jj homer, 1 t lesser, 2 d moffat, 3 n slevin, 4 r price, 5 and t blackburn 6 1 manchester academic health sciences centre, university of manchester, manchester, uk.
Transcranial and endonasal approaches 2 the pathology of tumors and tumor like. Skull base tumors or the treatment for them can affect the ability to speak and swallow due to damage or compression of the nerves responsible for these functions. Comprehensive techniques in csf leak repair and skull base. They are surrounded by delicate structures including blood vessels and nerves, and they can affect speech, hearing, smell and eyesight. The surgical approach depends upon the location and size of the tumor. Lateral skull base approaches in the management of benign parapharyngeal space tumors article pdf available in auris nasus larynx 423 september 2014 with 235 reads how we measure reads. The development of management of lateral skull base tumors has been rapid, in the past 40 years there has been a tremendous shift toward conservative therapy for benign lesions. Alfred ogden shares expertise on minimally invasive spine surgery dr. The cranial base, also referred to as skull base, is the area behind the eyes and nose that slopes down to the back of the head.
See musculoskeletal extremity treatments skull base tumors that originate in the brain or have spread from other organs metastatic tumors often require surgery, and may respond to radiation and chemotherapy approaches by. A diverse group, these tumors present unique management challenges because of their relative rarity, typically deep location, close proximity to critical neu. Skull base tumors can be classified based on their specific location in the head the tumor site or based on the cell structure and identifying characteristics of the tumor the tumor type. Aug 09, 2017 salivary gland tumors, as well as other malignancies of the head and neck, such as squamous cell carcinoma and esthesioneuroblastoma, may invade the skull base by proximity or by perineural invasion. Large tumors may need to be resected in several stages and may require more than one surgical approach. Three cases of chondrosarcoma, two of leiomyosarcoma, and one case each of synovial sarcoma, chondroid chordoma, myxoma, and fibromatosis were managed. Vestibular schwannomas are benign tumors that develop on the nerve that connects the ear to the brain. Adults and childrens skull base tumors and pituitary tumor. Skull base tumors are complex clinical and radiological entities.
However, many pathologies straddle the middle and posterior skull base and can be considered under the region of central skull base csb. Treatment for skull base tumors and conditions may include surgery, radiation therapy, chemotherapy andor observation. Understand the anatomical basis of various open and endoscopic skull base approaches in the management of malignant tumors of the anterior and anterolateral. Cranial base tumors are some of the most challenging, complex and technically demanding tumors to treat. Surgical management of skull base tumors sciencedirect. A chondrosarcoma is a type of cancer that starts in the cartilage at the junction of the bones of the skull base.
Doctors at rusk rehabilitation can prescribe speech and swallowing therapy to help restore these important abilities. Because of their rarity, they have received limited attention in the published medical literature. On the other hand, a very narrow definition would be limited to those tumors that arise from the bones and connective tissues that form the skull base. Even when these tumors are not cancerous, they can still cause problems as they grow and start to press against the brain, vital nerves or major blood vessels. Pdf management of malignant tumors of the anterior and. Our uci health skull base surgery team is experienced at diagnosing and treating the broad range of malignancies that can affect the skull base region. The management of tumors in and adjacent to the skullbase is challenging given the complex and critically important anatomy of the region and the wide diversity of tumor pathologies that may be encountered. Comprehensive surgical approaches to the skull base md anderson. The mainstay of treatment for skull base meningiomas is surgical resection. Comprehensive management of skull base tumors 1st edition. Altschul takes to twitter for world stroke day chat.
The term skull base tumors refers to a group of tumors that have a tendency to grow along various regions of the bottom part of the skull, mostly on the inside, but occasionally, also on the outside of the skull. Cranial base tumors are tumors that form at the base of the skull or spread to that location from a cancer elsewhere in the body. For patients with malignant skull base tumors, radiation therapy is. Comprehensive management of skull base tumors is divided into three sections consisting of. Skull tumors can be as with tumors anywhere else both primary and secondary, and benign or malignant. The treatment for a skull base tumor or condition depends on many factors, including. Skull base tumors can be difficult to diagnose and treat. Comprehensive management of skull base tumors, second edition out of printlimited availability. Skull base tumors form in the area under the brain and the bottom part of the skull. Otherwise, some intracranial tumors can pass through skull base to reach extracraneal spaces. To help navigate the complexities of contemporary multidisciplinary management of these patie. Modern microsurgical techniques, diagnostic imaging, intraoperative neuronavigation, and endoscopic technology have remarkably changed the concept of skull base surgery. Comprehensive management of skull base tumors 20081124.
Northwestern medicine treats a variety of skull base tumors and other conditions, including. They can cause hearing loss, ringing in the ear, loss of balance or facial numbness if untreated. Sinus and skull base tumors medical conditions rush. Alfred ogden shares his expertise in resident anatomy lab dr. Sometimes nasosinusal or vascular tumors can reach intracranial cavity. Skull base metastases sbm are rare among all tumors affecting the base of the skull. Malignant tumors that involve the skull base pose significant. For tumors, the extent of the tumor and whether it is benign or malignant. Cranial base tumors symptoms northwestern medicine. Benign skull base tumors benign tumors found in the skull base region can cause significant problems. Common skull base tumors include acoustic neuromas and meningiomas. Symptoms that may indicate a possible cranial base tumor include. Aug 23, 2018 the presenting features of a malignant skull base tumor tends to appear very slowly and gradually and may not be apparent, until the tumor has grown enough to cause pressure in the brain, the pituitary gland, or the optic nerve. Meningiomas are benign brain tumors that grow from the layers of tissue that protect the brain and spinal cord.
The contemporary surgical management of skull base tumors offers satisfactory surgical results and good to excellent clinical outcomes. Sinus and skull base tumors, which can be cancerous or noncancerous benign, grow in the area behind the eyes and nose that extends to the base of the skull. Treatment of skull base tumors md anderson cancer center. Vanderbilt skull base center skull base tumor care.
Altschul on twitter chat for world stroke day 2014 dr. For more information or to schedule a consultation, call us at 71445677 or 7144566966. The anatomy of this area had been described in detail. The spinal cord, multiple nerves and the major blood vessels of the brain, head and neck pass through openings in the skull base. However, their close proximity to nerves and major blood vessels can put you at risk for lifethreatening complications. Neurosurgery comprehensive management of skull base tumors. The skull base tumor program at md anderson cancer center is committed to providing the best care available for patients with benign or malignant tumors affecting the skull base.
Management of central skull base tumors springerlink. Uc irvine skull base surgery specialists are skilled at determining the type of tumor, its precise location and the best treatment method to preserve your function. Rarely, bone tumors such as chondrosarcoma, chordoma, osteosarcoma and others can arise in the skull base. In majority of the cases, skull base tumors grow within the skull, but in some cases they may also grow outside the skull. N2 the rich multidisciplinary environment in which skull base surgery has developed has allowed for significant progress in the field and has improved patient outcomes. Pdf lateral skull base approaches in the management of. Md anderson is one of the few cancer centers in the country with a specialized program for tumors of the skull base. Biostatistics unit, lombardi comprehensive cancer center. The broadest definition would include any tumor that involves or abuts the base of skull, thus including pituitary tumors and many tumors of the posterior fossa and cavernous sinus.
Comprehensive management of skull base tumors pdf free. The cranial base is conventionally classified into anterior, middle and posterior parts that correspond to the respective cranial fossa. Some malignant, or cancerous, skull base tumors grow more rapidly than benign tumors. Clinical research trials we are currently recruiting patients for the below clinical research trials.