Abstract SNACC-59

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A 3-year single centre experience of skull base surgery

1Cleland S, 2Toma A, 2Reddy U, 2Bradford R, 2Luoma V
1The Royal Marsden Hospital, London, , United kingdom; 2National Hospital for Neurology and Neurosurgery, London, , UK

Introduction
Acoustic neuromas are one of the most common intracranial tumours representing up to 90% of cerebellar-pontine angle tumours(1). Operative complications are variable but in the region of 20% when transient complications are excluded (2,3). Reported average length of hospital stay following skull base surgery is 4.9 days, with variation due to tumour size and post-operative complications(2). In our institution resection of acoustic neuromas is performed either by the translabyrthine or retrosigmoid approach with retrosigmoid approach favoured for large tumour size.

Aims
1. To audit our practice of skull base surgery and determine our patient population
2. To quantify the complications associated with our practice including length of hospital stay.

Methods
• Retrospective case-note review of all patient undergoing acoustic skull base surgery from January 2010 to July 2013
• Data collected included demographics, surgical data, post-operative complications and length of hospital stay
• Complications graded according to Clavien-Dindo classification of surgical complications. Major complications were considered to be Clavien-Dindo grade 3 and 4.


Results
103 patients identified with 100 case-notes reviewed [table 1: patient demographics]. 55% of patients experience ≥ 1 complication (including transient), 17% experienced a major complication [Grade 3&4: table 2]. Incidence of neurological complications was 8%, CSF leak 8% and abdominal haematoma 1%. Complications appeared to be associated with tumour size and retrosigmoid approach and this correlates with length of hospital stay. The majority of surgical procedures were for large tumours [>2.5cm].
Conclusions:
Although our sample size is small, our incidence of complications is comparable with published data [2,3]. Complications were more common in patients undergoing surgery for large tumours and retrosigmoid surgical approach in keeping with published data [3]. Length of hospital stay appeared to be associated tumour size, surgical approach and the presence/grade of complications.

References:
1. Giordano A. et al Acta Otorrinolaringologica Espanola 2012; 63(3):194-9
2. Sanna et al Otol Neurotol 2004;25:379-386
3. Sughrue et al J Neurosurg 2011;114:367-374

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