Surgical treatment of tumours of the skull base

Objective: To describe the special features of surgical removal of tumours of the skull base and to review a series of patients treated for skull base tumours. Design: A retrospective review of patients followed up for between six months and six years. Setting: A unit specialising in surgery of the skull base at a tertiary referral centre. Patients: Sixty-six patients with skull base tumours were referred to the unit between February 1984 and December 1989. Interventions: Fifty-six of the patients underwent complete or partial surgical removal of the tumour. Radiotherapy was used as primary treatment in 10 patients, for tumour recurrence in four patients and as adjuvant postoperative treatment in 10 patients. Results: In the majority of patients the tumours were benign and have been controlled or are considered cured. Of the seven patients with malignant tumours five have died and two are long-term survivors (one has multiple metastases). Three patients with histologically 'benign' tumours died of multiple metastases. There have been a total of 10 deaths in the series but only one occurred in the perioperative period. Cranial nerve palsy was the major postoperative complication. Conclusion: Modern microsurgical techniques and modern anaesthesia and intensive care skills lead to a cure in many patients with skull base tumours previously considered inoperable.