Failure of anterior skull base reconstruction for sinonasal carcinoma: consequence on the postoperative follow up. A multicentre evaluation of management.
CSF Leak
Watertight closure of anterior skull base
anterior skull base reconstruction failure
sinonasal carcinoma
Journal
Acta oto-laryngologica
ISSN: 1651-2251
Titre abrégé: Acta Otolaryngol
Pays: England
ID NLM: 0370354
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
pubmed:
6
5
2021
medline:
30
11
2021
entrez:
5
5
2021
Statut:
ppublish
Résumé
Numerous techniques for closure of the anterior skull base in cancer patients have a high success rate but management of failure is poorly documented. To standardize the post-operative follow-up after reconstruction surgery of the anterior skull base after removal for sinonasal carcinoma. Retrospective review of failure of anterior skull base reconstruction between 2005 and 2018 in a multicenter setting. Twenty four patients were included. Reconstruction failure was detected by a cerebrospinal (CSF) leak in 79.2%, by an infectious complication without CSF leak (i.e. meningitis) in 12.5%, and in 8.3% by extensive pneumocephalus. Failure was observed during the first week after surgery in 75% of patients, in the second week in 21%, and in 4% after day 15. The delay in discovery of the failure was associated with multilayer reconstruction ( After carcinologic resection of the anterior skull base, monitoring should be systematic during the first postoperative week. Surgical management of failure is not always necessary.
Sections du résumé
BACKGROUND
BACKGROUND
Numerous techniques for closure of the anterior skull base in cancer patients have a high success rate but management of failure is poorly documented.
OBJECTIVES
OBJECTIVE
To standardize the post-operative follow-up after reconstruction surgery of the anterior skull base after removal for sinonasal carcinoma.
MATERIALS AND METHODS
METHODS
Retrospective review of failure of anterior skull base reconstruction between 2005 and 2018 in a multicenter setting.
RESULTS
RESULTS
Twenty four patients were included. Reconstruction failure was detected by a cerebrospinal (CSF) leak in 79.2%, by an infectious complication without CSF leak (i.e. meningitis) in 12.5%, and in 8.3% by extensive pneumocephalus. Failure was observed during the first week after surgery in 75% of patients, in the second week in 21%, and in 4% after day 15. The delay in discovery of the failure was associated with multilayer reconstruction (
CONCLUSION AND SIGNIFICANCE
CONCLUSIONS
After carcinologic resection of the anterior skull base, monitoring should be systematic during the first postoperative week. Surgical management of failure is not always necessary.
Identifiants
pubmed: 33947299
doi: 10.1080/00016489.2021.1914858
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM