Management of squamous cell carcinomas of the skull-base
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TOPIC REVIEW
Management of squamous cell carcinomas of the skull‑base Colin G. Leonard1 · Vikram Padhye1 · Ian J. Witterick1 Received: 27 March 2020 / Accepted: 26 May 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose The purpose of this review is to assess the recent evidence regarding the management of squamous cell carcinoma of the skull-base and to discuss the implications of these findings on clinical practice. Method Free text Medline and MeSH term search of publications relating to Squamous Cell Carcinoma & Skull-base and Skull base, Neoplasm respectively. Multidisciplinary clinical guidelines were also reviewed. Results The primary search yielded a total of 271 papers which following initial review was reduced to 28. Secondary search yielded 56 papers. There were no randomised controlled trials relating to squamous cell carcinoma of the skull-base and as such this review is based on cohort studies, case series and expert opinion. Conclusion Squamous cell carcinoma (SCC) is the most common cancer occurring in the Head and Neck. Squamous cell carcinoma is also the most common cancer arising within the nose and sinuses of which skull-base squamous cell carcinoma is a rare subgroup. Evidence relating to the management and survival of skull-base SCC is based on expert opinion and. retrospective analyses Clinical examination and biopsy, imaging and a broad multidisciplinary team are key to the management of skull-base SCC. The information gathered should be used to guide informed discussion by suitably trained experts with patients regarding surgical approach, post-operative recovery and adjuvant or neoadjuvant treatments. The standard of care is currently to perform skull base resection with or without additional craniotomy, pedicled or free flap reconstruction in multiple layers and post-operative radiation (usually photons or protons). Open approaches have traditionally been the mainstay, however in certain cases endoscopic approaches can yield equivalent results and offer many advantages. Despite advances in care survival remains poor with a nearly one in five risk of nodal recurrence within two years. Keywords Squamous cell carcinoma · Skull-base · Endoscopic · Craniofacial · Surger
Introduction The anterior skull-base, involving the posterior table of the frontal sinus, the ethmoid, the planum sphenoidale and the anterior clinoid process, separates the anterior cranial fossa from the nasal cavity, sinuses and orbits. The anterior skullbase partitions the intracranial and extracranial compartments and lies in an area dense with major vessels and cranial nerves. We will discuss the issues surrounding diagnosis
* Ian J. Witterick [email protected] Vikram Padhye [email protected] 1
Department of Otolaryngology, Head and Neck Surgery, University of Toronto, Toronto, Canada
and management of squamous cell carcinoma (SCC) in the anterior skull-base. The surgical approach to the skull-base may require control of the anterior and posteri
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