Surgical Outcome of Anterior Skull Base Approach for Combined ENT and Neurosurgical Lesions

Authors

  • FAZAL -I-WAHID Departments of ENT, Head and Neck Surgery,Postgraduate Medical Institute, Lady Reading Hospital, Peshawar
  • HABIB -UR-REHMAN 1Departments of ENT, Head and Neck Surgery,Postgraduate Medical Institute, Lady Reading Hospital, Peshawar
  • MUHAMMAD SALEEM Neurosurgery Postgraduate Medical Institute, Lady Reading Hospital, Peshawar
  • Mumtaz Ali Neurosurgery Postgraduate Medical Institute, Lady Reading Hospital, Peshawar

Keywords:

Fungal rhino sinusitis, combined skull base approach, advanced angiofibroma, Anterior skull base, Esthesioneuroblastoma

Abstract

Objective: To determine surgical outcome of Anterior Skull Base approach for combined ENT and Neurosurgical Lesions.
Material and Methods: This descriptive study was conducted at the departments of ENT, Head, Neck Surgery and Neurosurgery Postgraduate Medical Institute (PGMI) Lady Reading Hospital Peshawar from March 2003 to Feb. 2008, with a total duration of five years. All these patients were admitted in ENT department. These patients were evaluated in terms of detailed history, thorough examination and radiological investigations. Incisional biopsy of the nasal mass was taken in cases where angiofibroma was excluded clinically, and then proper approach for excision of the lesion was planned. A well informed consent was taken from patient explaining the procedure, its risks, benefits and associated complications. The intracranial lesion was completely excised by neurosurgeons with help of microscope while the extracranial portion of the lesion was excised by ENT surgeon. The specimen of the lesions was examined by Histopathologist.
Results: This study included 23 patients in the age range of 12 – 51 years, mean age 25 years. Eighteen patients were male and five were female with female to male ratio of 1:3.6. These patients presented mainly with comp-laints of nasal obstruction, epistaxis and headache. CT scans were performed in all 23 cases (100%) while MRI in 5 cases (21.73%). These patients presented with advanced disease on radiological findings and they were treated by combined approach by Neurosurgeons and Otorhinolaryngologists. On histopathology of the specimen angiofibroma was on top. Two patients were subjected to radiotherapy postoperatively. There was no mortality and no recurrence of the disease.
Conclusion: The anterior skull base approach has good surgical outcome in terms of complete clearance of the disease and minimum morbidity for combined neurosurgical and ENT lesions irrespective of the nature of the lesion.

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Published

2018-11-04

Issue

Vol. 15 No. 2 (2011): July-December

Section

Original Articles

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The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).