A Protocol for Reconstructing Complex Lateral Skull Base Defects: Two Decades of Tertiary Care Experience

Area of Science:

• Neurosurgery and Otolaryngology
• Skull Base Surgery
• Oncology

Background:

• Complex lateral skull base pathologies require specialized management.
• A multidisciplinary approach is crucial for optimal patient outcomes.
• High-volume tertiary centers play a key role in developing surgical protocols.

Purpose of the Study:

• To describe a multidisciplinary protocol for lateral skull base pathology resection and reconstruction.
• To share over two decades of experience from a UK-based tertiary referral center.
• To provide a structured and reproducible approach for managing complex cases.

Main Methods:

• Retrospective descriptive analysis of institutional practice.
• Outlined a 20-year multidisciplinary protocol involving ENT, neurosurgery, plastic surgery, anesthesia, radiology, oncology, and nursing.
• Detailed surgical planning, intraoperative decision-making, perioperative care, and rehabilitation.

Main Results:

• The protocol facilitated safe and effective management of diverse lateral skull base lesions.
• Achieved high rates of complete resection and functional reconstruction with acceptable morbidity.
• Successfully navigated complex anatomy and tumor extent through coordinated team planning.

Conclusions:

• Effective lateral skull base pathology management necessitates a highly coordinated multidisciplinary strategy.
• The described 20-year protocol offers a structured, reproducible approach.
• This protocol can serve as a valuable reference for other high-volume skull base surgery centers.