Averting Delayed Complications of Open Anterior Skull Base Surgery

Area of Science:

• Neurosurgery
• Otolaryngology
• Oncology

Background:

• Anterior skull base surgery, while feasible, carries risks of severe complications, morbidity, and mortality.
• Despite improvements, postoperative complications remain a challenge in skull base surgery.
• This study addresses late complications in open anterior skull base surgery.

Purpose of the Study:

• To report late complications in a large series of patients undergoing open anterior skull base surgery.
• To identify predictors for delayed complications.
• To propose methods for averting these complications.

Main Methods:

• Retrospective chart review of 301 anterior open skull base surgeries (2000-2016).
• Analysis of complications including wound, central nervous system, and orbital issues.
• Multivariate analysis to identify complication predictors.

Main Results:

• Delayed complications occurred in 28.2% of patients.
• Malignant pathology, intracranial extension, and prior radiochemotherapy predicted complications.
• Lower complication rates were observed in the later study period (after 2007).

Conclusions:

• Delayed complications following anterior skull base surgery are declining.
• Advancements in imaging, surgical techniques, reconstruction, and multidisciplinary teams contribute to this decline.
• A revised treatment protocol was associated with reduced complication rates.