Clinical analysis of resection and dura skull base reconstruction of cranionasal communication tumor in 31 cases
Objective:To explore the methods of resection,dura and skull base repair and reconstruction of cranionasal communication tumor.Methods:Data of 31 patients with cranionasal communication tumor who un-derwent dura and skull base reconstruction after tumor resection from 2018 to 2022 were collected.Follow-up las-ted for 3 to 41 months.Results:A total of 31 patients were enrolled,including 20 males and 11 females.The ages ranged from 19 to 74 years,with a median age of 57 years old.There were 17 benign lesions(one case of hemangi-oma,one case of Rathke cyst,one case of squamous papilloma,one case of craniopharyngioma,two cases of me-ningocele,two cases of varus papilloma,two cases of meningioma of grade Ⅰ,three cases of schwannoma,four cases of pituitary tumor)and 14 malignant lesions(one case of osteosarcoma,one case of poorly differentiated car-cinoma,two cases of varus papilloma malignancy,two cases of olfactory neuroblastoma,two cases of adenocarci-noma,two cases of adenoid cystic carcinoma,four cases of squamous cell carcinoma).Sixteen cases underwent nasal endoscopy combined with craniofacial incision and 15 cases underwent nasal endoscopy surgery alone.Com-plete resection of the mass and dura and skull base reconstruction were performed in all 31 patients,and free graft repair was performed in 8 cases(fascia lata in 5 cases and nasal mucosa in 3 cases).Twenty-three cases were re-paired with pedicled flaps(septal mucosal flap alone in 11 cases,septal mucosal flap combined with free graft in 6 cases,and cap aponeurosis combined with free graft in 6 cases).Eight out of 31 patients underwent skull base bone repair.Postoperative cerebral hemorrhage occurred in 1 case,cerebrospinal fluid leakage in 1 case,intracra-nial infection in 2 cases.All patients were successfully treated without severe sequelae.Cerebrospinal fluid leakage and intracranial infection occurred in one patient after radiotherapy,who recovered after conservative treatment.All 17 patients with benign lesions survived.Thirteen out of 14 patients with malignant lesions received radiother-apy after surgery,nine survived without recurrence,five cases recurred,of which 2 survived with tumor,one un-derwent reoperation and 2 died.Conclusion:Cranionasal communication tumors are high-risk diseases of anterior and middle skull base,and various surgical repair methods could be selected after complete resection of the tumor.Successful reconstruction and multidisciplinary cooperation are crucial for treatment outcome.
dura and skull base reconstructioncranionasal communication tumorfascia latanasal septum mucosa flapmultidisciplinary collaboration
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