BACKGROUND: The analysis of the surgical indications and the follow-up, stressing the surgical complications and efficiency of a team approach for the advanced tumors involving the anterior skull base are the purpose of the present study. METHODS: The authors present a retrospective evaluation of 46 patients who underwent resections of advanced tumors involving the anterior skull base, which were reconstructed with free flaps from May, 1990 to July, 2002. Those patients have been treated by the skull base surgical team of INCA. RESULTS: The commonest resected structures were: the orbit (76.5%), maxilar sinus (76.5%), sphenoidal sinus (63.8%), nasal cavity walls (59.5%) and palate (42.5%). The dura-mater was involved in 32,6% of the patients. Free-flap reconstructions employing the rectus abdominis muscle flaps were the leading procedure in 93.5% of patients. The successful rate of the free-tissue transfer was 97.8%. Complications occurred in 58,6% of patients, the most frequent were: local infection (21.7%), cerebrospinal fluid leakage (15.3%), meningitis(6.5%) and hematoma (6.5%). CONCLUSIONS: The microvascular free-tissue transfer reconstruction allows more extensive resections of those tumors with safety borders, presenting acceptable complication rates, offering the patients a better quality of life, longer life expectance with low incidence of recurrent disease.
Skull base neoplasms; Microsurgery; Reconstructive surgical procedures
