Failure of anterior skull base reconstruction for sinonasal carcinoma: consequence on the postoperative follow up. A multicentre evaluation of management
Résumé
Numerous techniques for closure of the anterior skull base in cancer patients have a high success rate but management of failure is poorly documented.
To standardize the post-operative follow-up after reconstruction surgery of the anterior skull base after removal for sinonasal carcinoma.
Retrospective review of failure of anterior skull base reconstruction between 2005 and 2018 in a multicenter setting.
Twenty four patients were included. Reconstruction failure was detected by a cerebrospinal (CSF) leak in 79.2%, by an infectious complication without CSF leak (i.e. meningitis) in 12.5%, and in 8.3% by extensive pneumocephalus. Failure was observed during the first week after surgery in 75% of patients, in the second week in 21%, and in 4% after day 15. The delay in discovery of the failure was associated with multilayer reconstruction (p
After carcinologic resection of the anterior skull base, monitoring should be systematic during the first postoperative week. Surgical management of failure is not always necessary.