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12- Year Retrospective Analysis of 2,993 Consecutive Skull Base Cases

Perry Mansfield MD., FRCSC., Hannah Goldman, Hofstra University, Natalya Sarkisova BS., University of Oregon.

Objective:

A 12-year retrospective and ongoing series of skull base case presentations with diagnostic and therapeutic data comprised of 1,429 prospective cases and 2,993 total cases. Pre-treatment symptomatology, physical examination, radiographic findings, treatment strategies, rehabilitative therapies, were collaboratively discussed and recommendations were made. Data was analyzed and findings reported.

Methods:

The Skull Base Conference is a regional biweekly meeting open to physicians in all specialties with subspecialty training in Neurosurgery, Head & Neck Surgery, Plastic Surgery, Oral-Maxillofacial Surgery, Pathology, Oncology, Neuroradiology, Ophthalmology, Radiation Oncology, Prosthodontics, and other ancillary personnel. There were thirty-four primary presenting physicians; however, diagnosis and treatment decisions were developed and outcome analytics were discussed by all those present.

The study includes a cataloged series of patient data collected and organized by specific physician, physician specialty, date of presentation, gender and age of patient, clinical, radiographic and pathologic diagnosis, and future course of action (if specified). The analysis focuses on Skull Base Conference presentations that took place in the months between January 2004 and July 2016.

Results:

Extensive data for this series will be presented, including disease prevalence, diagnosis frequency, tumor staging, gender frequency, age of presentation, and outcome metrics will be discussed. The average age of the patients presented was 56.13 years old, with a range of 15 to 97. There were 732 male and 694 female prospective patients. The total number of diagnoses was 211. The most frequent diagnosis was vestibular schwannoma/acoustic neuroma, with 181 occurrences, 12.7% of the total prospective cases presented. Of the presenting physicians, the predominant specialty was Head & Neck surgery, which presented a total of 838 cases. The average number of cases presented per year was 240.9 and the average number of prospective cases per year was 112.3. Over the 12-year span, a total of 233 conferences were conducted.

Discussion:

This substantial patient experience supports the need for multidisciplinary collaboration in skull base diagnoses. It supports the need for improvement in data tracking by skull base physicians and surgeons in prospective treatment planning by integrating in-hospital and outpatient data portals for long term analysis of best practices.

Bibliography:

Hulou, M. Maher, Marcio S. Rassi, Kaith Almefty, Wenya Linda Bi, Ian F. Dunn, Timothy R. Smith, and Ossama Al-Mefty. "130 Skull Base Chordomas in Children and Young Adults." Neurosurgery 63 (2016): 153. Web.

Kelly, Hillary R., and Hugh D. Curtin. "Imaging of Skull Base Lesions." Handbook of Clinical Neurology 135 (2016): 637-57. Web.

Kakkar, Aanchal, Aruna Nambirajan, Vaishali Suri, Chitra Sarkar, Shashank Kale, Manmohan Singh, and Mehar Sharma. "Primary Bone Tumors of the Skull: Spectrum of 125 Cases, with Review of Literature." J Neurol Surg B Journal of Neurological Surgery Part B: Skull Base 77.4 (2016): 319-25. Web.

Marszałek, Andrzej, Łukasz Szylberg, and Sławomir Wiśniewski. "Pathologic Aspects of Skull Base Tumors." Reports of Practical Oncology & Radiotherapy 21.4 (2016): 288-303. Web.

Spinazzi, Eleonora F., Mohammad T. Abboud, Pariket M. Dubal, Sunil P. Verma, Richard Chan Woo Park, Soly Baredes, and Jean Anderson Eloy. "Laryngeal Adenocarcinoma Not Otherwise Specified: A Population-Based Perspective." The Laryngoscope (2016): n. pag. Web.

Boari, Nicola, Filippo Gagliardi, Andrea Cavalli, Marco Gemma, Luca Ferrari, Paola Riva, and Pietro Mortini. "Skull Base Chordomas: Clinical Outcome in a Consecutive Series of 45 Patients with Long-term Follow-up and Evaluation of Clinical and Biological Prognostic Factors." Journal of Neurosurgery 125.2 (2016): 450-60. Web.

Bhojwani, Amit, Aykut Unsal, Pariket M. Dubal, Kristen A. Echanique, Soly Baredes, James K. Liu, and Jean A. Eloy. "Frontal Sinus Malignancies: A Population-Based Analysis of Incidence and Survival." Otolaryngology -- Head and Neck Surgery 154.4 (2015): 735-41. Web.

Rissi, Daniel R. "A Retrospective Study of Skull Base Neoplasia in 42 Dogs." Journal of Veterinary Diagnostic Investigation 27.6 (2015): 743-48. Web.

Dubal, Pariket M., Amit Bhojwani, Tapan D. Patel, Omry Zuckerman, Soly Baredes, James K. Liu, and Jean A. Eloy. "Squamous Cell Carcinoma of the Maxillary Sinus: A Population-Based Analysis." The Laryngoscope 126.2 (2015): 399-404. Web.

Lund, Valerie J., and William I. Wei. "Endoscopic Surgery for Malignant Sinonasal Tumours: An Eighteen Year Experience." Rhinology 53.3 (2015): 204-11. Web.

Dutta, Rahul, Pariket M. Dubal, Peter F. Svider, James K. Liu, Soly Baredes, and Jean A. Eloy. "Sinonasal Malignancies: A Population-based Analysis of Site-specific Incidence and Survival." The Laryngoscope 125.11 (2015): 2491-497. Web.

Banuchi, Victoria, Jonathan Mallen, and Dennis Kraus. "Cancers of the Nose, Sinus, and Skull Base." Surgical Oncology Clinics of North America 24.3 (2015): 563-77. Web.

Qingzhuang, Liang, Wu Yuehuang, Li Dezhi, and Xu Zhengang. "Treatment and Prognosis of the Carcinoma Arising from Nasal and Sinonasal Inverted Papilloma: Report of 62 Cases and Systematic Review." Chinese Journal of Oncology 37.2 (2015): 133-37. Web.

Villwock, Jennifer A., Mark Villwock, Eric Deshaies, and Parul Goyal. "Significant Increases of Pituitary Tumors and Resections from 1993 to 2011." International Forum of Allergy & Rhinology 4.9 (2014): 767-70. Web.