Abstract
Introduction:
The result of craniofacial resection of malignancies done by junior neurosurgical faculty in the context of multidisciplinary surgical management is not known.
Methods:
All patients with malignancies who underwent craniofacial resection done by a single junior faculty neurosurgeon (SSP) newly in practice starting in 2003 to 2005 were retrospectively reviewed. The goal was to determine the complication rate and degree of resection achieved by junior neurosurgical faculty.
Results:
Sixteen consecutive patients underwent resection (6 transbasal, 10 combined craniofacial) for curative intent. Ten were treated for salvage. Common histologies included sarcoma (n = 5) and squamous cell carcinoma (n = 3). Margins were negative in 11 and positive in 5. Eleven were resected en bloc. Five underwent dural resections. Tumor was inadvertently left behind in 1, requiring secondary endoscopic resection. Average follow-up was 7.3 months. Nobody died. Neurosurgical complications occurred in 3 (wound infection in 2, and cerebrospinal fluid leak in 1). Incision and drainage of the facial flap was required in 2. Average hospital stay was 8.3 days with everyone being discharged home.
Conclusions:
When comparing these data to historical controls of craniofacial resection for malignancies, it does not seem that resections performed by junior neurosurgical faculty do impact morbidity or degree of oncological resection in a negative sense. Whether survival is affected cannot be determined due to short follow-up. Although the standby presence of senior faculty is recommended, it does not seem to be absolutely required if junior faculties had special training in craniofacial resection during residency or fellowship.