Complications in skull base surgery for malignancy

Objectives: To review a consecutive series of skull base surgeries, establish the rate of complications, and outline their prevention and management. Study Design: A retrospective review of 107 consecutive intracranial/extracranial operations performed for malignancy that transgresses the skull base. Methods: The hospital charts of 107 operations performed on 98 patients at the University of California at Davis Medical Center, The type of operation, cause of death, and complications were noted. Results: The complication rate was 50.5%. Forty-eight patients had no complications. There were six perioperative deaths. The most common surgical complications were cerebrospinal fluid leak (11.2%), meningitis (4.8%), and wound breakdown (15%). The most common medical complications were pneumonia (6.5%), cardiac disturbance (4.7%), and electrolyte imbalance (3.7%). The only prior treatment that was accompanied by a significant increase in complications was previous surgery. Conclusions: Complications occurred in approximately half of the patients who had cranial base surgery for the intracranial spread of head and neck cancer. The perioperative death rate is less than 4%. The major complications were at an acceptable rate.