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J Neurol Surg B Skull Base 2017; 78(01): 011-017
DOI: 10.1055/s-0036-1583948
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Complications of Open Approaches to the Skull Base in the Endoscopic Era

Justin D. Miller
1   Department of Otolaryngology–Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
,
Robert J. Taylor
2   Department of Otolaryngology–Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, United States
,
Emily C. Ambrose
3   Department of Otolaryngology–Head and Neck Surgery, University of Colorado, Denver, Colorado, United States
,
Jeffrey P. Laux
4   Translational and Clinical Sciences Institute, University of North Carolina, Chapel Hill, North Carolina, United States
,
Charles S. Ebert
1   Department of Otolaryngology–Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
,
Adam M. Zanation
1   Department of Otolaryngology–Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, United States
› Author Affiliations
Further Information

Publication History

27 August 2015

27 March 2016

Publication Date:
02 June 2016 (online)

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Abstract

Objective It is important to characterize the developing complication profile of the open approach as it becomes reserved for more complex disease during the endoscopic era. Our objective was to characterize complication rates of current open skull base surgery.

Design Retrospective chart review.

Setting Tertiary care center.

Participants The study group consisted of 103 patients and 117 open skull base surgeries were performed from 2008 to 2012.

Main Outcome Measures Intraoperative/postoperative complications.

Methods Fisher exact test and Wilcoxon rank sum test evaluated for associations of complications with potential risk factors.

Results Postoperative complications occurred in 53 (45%) cases, of which 36 (31%) were major complications. Malignancy, dural grafting, age, and obesity were not associated with complications. Flap reconstruction was associated with increased complication rates (odds ratio = 2.27; 95% confidence interval: 1.03–5.04).

Conclusion The open approach is increasingly utilized for only the most complex lesions, and selection bias cannot be overstated in comparative series. This study suggests that current open complication rates may be above those cited from prior studies, and patient and physician expectations should be adjusted accordingly.

Keywords

open approach - skull base - complications

Note

This study was performed at the University of North Carolina Hospitals, Chapel Hill, NC.


 

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