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Updated: May 6, 2026

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery
Published on: July 5, 2021
[Skin cancers infiltrating the skull base].
P Pasche1, M Broome, R T Daniel
1Service d'ORL et de chirurgie cervico-faciale, CHUV, 1011 Lausanne. philippe.pasche@chuv.ch
Aggressive facial skin cancers, though rare, can invade deep tissues and bone. Advanced treatments offer curative options, but careful patient selection is crucial for therapeutic benefit.
Area of Science:
- Oncology
- Craniofacial Surgery
- Dermatology
Background:
- Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) of the face typically have a good prognosis.
- A subset of these facial skin cancers exhibits aggressive behavior, infiltrating deep soft tissues and bone.
Observation:
- Tumor invasion can follow embryonic fusion lines or facial nerves, potentially reaching craniofacial skeleton and intracranial structures.
- This aggressive behavior may manifest years after initial treatment.
Findings:
- Advances in craniofacial surgery, reconstruction techniques, and conformational radiotherapy enable curative treatments for advanced cases.
- Despite treatment advancements, these tumors present a limited prognosis.
Implications:
- Rigorous patient selection is essential for achieving therapeutic benefit in advanced facial skin cancers.
- Multidisciplinary approaches combining surgery, radiation, and reconstruction are vital for managing these complex cases.
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