Subcranial craniotomy in surgical management of advanced oral cavity malignancies: a technical note
Craniofacial resection is the technique of choice for tumors of the oral cavity or paranasal sinus extending close to the skull base of middle cranial fossa. Here we would like to describe a new technique of approaching these tumors through the facial incision itself.
All patients treated with this technique at our institute were included in this retrospectively analyzed case series. The pathological clearance margins, complications and outcomes were studied.
A total of nine patients underwent resection of tumor with the subcranial approach. There were seven males and two female patients. Mean age was 50.66 years (22–72 years). The diagnosis was squamous cell carcinoma in five patients, adenoid cystic carcinoma in three patients and alveolar soft part sarcoma in one patient. A lip split incision and mandibulotomy/mandibulectomy was done in seven patients; a Weber–Fergusson incision was used in one patient and details were not available in one other patient. Reconstruction was done with anterolateral thigh flaps with or without titanium mesh for all the patients. One patient developed thalamic infarct and was managed conservatively. None of the other patients had complications related to the craniotomy. The infratemporal fossa margin was close/involved in two patients (22.22%). Eight patients received adjuvant therapy without delay. One patient, who had received radiation previously, did not receive adjuvant radiation.
This technique aims to reduce morbidity without compromising on the oncological outcomes for tumors extending short of or up to the skull base.
KeywordsInfratemporal fossa carcinoma Craniofacial resection T4b oral cancer Peri neural spread Carcinoma buccal mucosa Carcinoma maxilla
No funding was received for the conduct of this study.
Compliance with ethical standards
Conflict of interest
Hamsa Nandini declares that she has no conflict of interest. Kiran Mariswamappa declares that he has no conflict of interest. Naveen Hedne declares that he has no conflict of interest. Srikamakshi Kothandaraman declares that she has no conflict of interest. Akanksha Saxena declares that she has no conflict of interest. Vijay Pillai declares that he has no conflict of interest. Vivek Shetty declares that he has no conflict of interest. Vidyabhushan R declares that he has no conflict of interest. Komal Prasad declares that he has no conflict of interest. Moni Abraham Kuriakose declares that he has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in the study.