Authors (including presenting author) :
NG Chat Fong (1), MAK Hoi Kwan Calvin (1), CHEUNG Fung Ching (1), NG Wai Shun (2), CHUNG Wai Yin William (2), YUEN Kwok Lai (3)
Affiliation :
(1) Department of Neurosurgery, Queen Elizabeth Hospital, Hong Kong, (2) Department of Ear, Nose and Throat, Queen Elizabeth Hospital, Hong Kong,(3) Department of Ophthalmology and Visual Sciences, Hong Kong Eye Hospital, Hong Kong
Introduction :
Complex skull base tumors pose difficulties in management. It requires expertise from different specialties, for example, Ophthalmology and Ear, Nose, and Throat. A multidisciplinary skull base team was established in Jan 2018 in order to facilitate patient management. The workflow for patient counseling, preoperative disease management, OT planning, joint consent attainment, multi-team operation, postoperative management, and follow-ups were streamlined. The study aims to review the surgical outcomes of skull base operations collaborated with otorhinolaryngologists and Ophthalmologists.
Objectives :
To review the surgical outcome of skull base operations collaborated with Otorhinolaryngologist and Ophthalmologist.
Methodology :
This was a retrospective review of skull base operation collaborated with Otorhinolaryngologist and Ophthalmologist in Queen Elizabeth Hospital from January 2018 to August 2022.
Result & Outcome :
There were 48 multidisciplinary skull base operations performed from January 2018 to August 2022. Otorhinolaryngology participated in 29.2% of total operations while Ophthalmology participated in 81.3%. Most prevalent age group was 60-69 year-old, accounting for 35.4% of total patients, followed by 50-59 (22.9%) and 40-49 (16.7%). Male and female were equally distributed. About two-third of cases were benign in pathology, commonly Schwannoma, meningioma, and cavernous hemangioma. One-fifth of cases were malignant and the remaining included trauma, osteonecrosis. The most operated site was orbital apex (20.8%), followed by mastoid (10.4%), then sphenoid ridge, trigeminal nerve and orbital extraconal space (each accounting for 8.3%). Almost 70% of operations utilized solely endoscopic approach, while 16.7% were done openly and 14.6% adopted combined approach. Among endoscopic approaches, over 60% were transorbital and 25% were endonasal. Notably, there were 4 cases of Bi-portal operation and a case of Tri-portal operation on parapharyngeal space tumor, which was first reported application in literature.
This study illustrates the importance of multidisciplinary approaches on tailor-made management of complex skull base pathologies.
