Complications of skull base tumor surgery and their avoidance

Abstract

We describe complications of skull base surgery, and emphasize the importance of preoperative planning and strategies for their avoidance. A requirement of skull base reconstruction is water-tight closure of the dural defect with free pericranium or fascia lata. Vascularized tissues may then be utilized, depending on the degree of the tissue defect, to disclose communications to nasootologic regions and to minimize dead space. Postoperative cerebrospinal fluid leakage can be cured by spinal drainage if reconstruction is performed correctly. Small bridging veins and cortical veins should not be sacrificed during approach, since they can support collateral circulation for patients with venous injury around the tumor during resection. A severed facial nerve should undergo primary repair either by direct suturing or by nerve grafting, because of its high capacity for regeneration. Taking into consideration the complications related to each skull base approach, surgical strategy should be planned based on the individual case.