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The journal «ONCOSURGERY» 2014, Vol.6, No 1

Quality of life in patients with tumors of pterygopalatine and infratemporal fossae prior and after surgical treatment

Belov IYu, Gulyaev DA, Chebotarev SYa, Primak NA, Gorban VV

Russian Research Neurosurgical Institute. prof. AL Polenova Saint-Petersburg State Medical University, Acad. IP Pavlov Department of Operative Dentistry and Maxillofacial Surgery, Saint-Petersburg, Russia
Contact: Gorban Vitaly Valerievich, e-mail:

The means for improvement of quality of life in patients with tumors in pterygopalatine and infratemporal fossae are reviewed in the article.

Material and methods: The study was based on analysis of full examination and surgical treatment of 59 patients with tumors in pterygopalatine and infratemporal fossae and adjacent regions, treated in II department of surgery for brain and spinal tumors in A.L. Polenov RRIN in the period from 2004 to 2013. The age of patients varied from 14 to 71 years old. There were 27 men and 32 women, the ratio male/female accounted for 1.19:1. All patients were divided into 3 main groups: group 1 – patients with craniobasal surgical approaches, this group included 29 patients, 12 of them were with benign tumors and 17 with malignant lesions; group 2 – patiwnts with transfacial approaches, this group included 15 patients, 3 of them were with benign tumors and 11 with malignant lesions; group 3-15 patients with giant malignant tumors of anterior lateral skull base, the main surgical method in this group consisted of resection en bloc followed by reconstruction of surgical defect by regional flaps.

Results: While comparing the groups there were significant differences in general status of patients, status by Karnofsky scale and quality of life defined by EORTC QLQ.

The most number of severe patients before surgery was in the group 3 (26.67%) and in the group 2 (13.33%), while there were no such patients in group 1. On the other hand, the proportion of patients with satisfactory general status in group 1 (68.97%) was significantly higher than those in other groups (26.67% and 33.33%, respectively).

For Karnofsky scale and EORTC QLQ at the date of admission, similar data were obtained indicating on better social adaptation of patients in group 1 and worse in group 2 and 3.

There was an inverse tendency at the date of discharge. The proportion of patients with satisfactory status in group 1 markedly reduced (44.82%), in addition two severe patients appeared. On the other hand, the absolute majority of discharged patients had satisfactory general status (86.66%). In group 3 the proportion of severe patients reduced from 26.67% to 7.14%.

Conclusions: The dynamics of patients’ general status and quality of life was directly associated with adequate excision rate. Lower percent of total removal of tumor in patients with craniobasal approaches resulted in significant worsening of general status and quality of life. On the other hand, the inverse tendency occurred in group 2 and 3. This can be easy explained by the fact that total tumor removal reverses clinical manifestation in the majority of cases. For incomplete tumor removal residual symptoms of the disease may become worse and new symptoms directly associated with intervention may be developed.

Thus, transfacial approaches assessed in this study allowed to perform total removal en bloc and to provide good general status and to imrove quality of life in the post-perative period.

KEY WORDS: skull base tumor, pterygopalatine fossa, infratemporal fossa.


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