Comprehensive Management of Skull Base Tumors PDF

Preface

The management of patients with tumors of the skull base has evolved significantly in the last two decades.Major advances have been achieved in the surgical management of these patients, particularly in the areas of tumor resection and surgical reconstruction. These advances can be mainly attributed to the collaborative efforts of dedicated teams representing various surgical disciplines including neurosurgery, head and neck surgery, neuro-otology, oromaxillofacial surgery, ophthalmology, and plastic and reconstructive surgery. Meanwhile significant advances in radiation delivery using various methods of conformal therapy, including three-dimensional computerized tomography (3D-CT), intensity-modulated radiation therapy (IMRT), proton beam therapy, and stereotactic radiation, as well as advances in chemotherapy and targeted biologic therapy have added significantly to the menu of treatment options for patients with tumors of the skull base. Although there are many excellent references describing the surgical management of patients with tumors of the cranial base, this textbook is intended to be a comprehensive guide to help navigate the complexity of contemporary multidisciplinary management of these patients. In addition, we hope that this reference will also provide the reader with deeper understanding of the unique biologic behavior and the underlying molecular and genetic aberrations of the various tumor types originating from or involving the cranial base, and the potential for these molecular derangements to be putative targets for future development of more effective biologic therapy. To address these goals, we have organized the book in three sections: general principles, site-specific chapters, and tumor-specific chapters.

Section one covers general topics pertinent to all patients with neoplasms of the skull base, regardless of specific location or tumor type. These topics include anatomy, pathology, genetics, clinical evaluation, diagnostic imaging, anesthesia, minimally invasive surgery, surgical reconstruction, prosthetic rehabilitation, radiation and radiobiology, chemotherapy, evaluation and rehabilitation of speech and swallowing, functional outcomes and quality of life issues, neurocognitive assessment, and cerebrovascular management.

Section two covers site-specific information regarding the various anatomic regions of the cranial base, including surgical anatomy, regional pathology, differential diagnosis, clinical assessment, diagnostic imaging, and surgical approaches. This regional classification includes the anterior cranial fossa, sinonasal region, nasopharynx, clivus, infratemporal fossa, parapharyngeal space, temporal bone, sella turcica, middle cranial fossa, petrous apex, cerebellopontine angle, jugular foramen, and craniovertebral junction.

Section three covers comprehensive multidisciplinary discussion of tumor-specific topics such as tumor incidence and epidemiology, pathology, staging, treatment, outcome, and prognosis. This section covers the following tumors of the cranial base: squamous and nonsquamous cell carcinoma, olfactory neuroblastoma, melanoma, sarcomas, angiofibromas and other vascular tumors, chordomas and chondrosarcomas, meningiomas, schwannomas, paragangliomas, pituitary adenomas, craniopharyngiomas, epidermoid and dermoid cysts, fibro-osseous lesions, and metastatic tumors.

This organizational schema is intended to provide a simple yet comprehensive way for readers to find the information they need. For example, the reader who wants to know about the latest advances in radiation therapy of skull base tumors is referred to the first section, a reader who has a patient with a tumor of the petrous apex is referred to the second section, and another who wants to know all the available treatment options and prognostic factors for esthesioneuroblastoma is referred to the third section.With such an organizational structure, some redundancy is unavoidable, but not, as you will see, detrimental. As with any textbook, some omissions are inevitable and we hope our readership will forgive any shortcomings of this work. We believe that the greatest value of this book is the incredible expertise of the contributing authors. They truly represent the world's experts on their specific topics. We are honored by their contribution and humbled by their graciousness to join us in this work.