Craniofacial resection. An analysis of 73 cases

To determine the morbidity and mortality associated with a large series of patients undergoing craniofacial resection at one institution. The series is also analyzed with respect to pathology, disease recurrence, and role of adjuvant therapy.

Retrospective review with a mean follow-up of 3 years (range, 6 months to 8 years).

Tertiary care, urban referral center.

The study included 73 consecutive patients (39 male and 34 female). Ages ranged from 13 to 78 years with a mean of 53.1 years. All patients had benign or malignant tumors of the paranasal sinuses.

Morbidity associated with craniofacial resection was categorized as follows: early (within 30 days of surgery) or late (> 30 days); neurologic, ocular, or infectious.

Overall morbidity rate was 63%, and the mortality rate was 2.7%. Of the patients who had complications develop, 26 had development of major morbidities and there were two mortalities. The most common complications were transient alteration in mental status (15 patients), diplopia (11 patients), cerebrospinal fluid leak (10 patients), and osteomyelitis of the frontal bone flap (eight patients).

Craniofacial resection is an effective surgical treatment for paranasal sinus tumors. The mortality rate is acceptable and morbidity appears directly related to experience with the procedure. Infectious complications were the most devastating.