ИСТИНА

Introduction. Approximately 50% of all malignant tumors are epithelial tumors and affect the anterior skull base. Tumors of the paranasal sinuses grow asymptomatically for a long time and are more often found in the late or end stages: the frequencies of T1 and T4 stages are 10% and 55% respectively. It requires an interdisciplinary approach and the implementation of a comprehensive treatment. Objective.The setting of precise indications and contraindications to the surgery. To present an optimal method for preparing the patient for surgery. The choice of surgical technique (biopsy, transcranial tumor removal, endoscopic tumor removal, combined tumor removal, craniofacial resection). The choice of skull base defect reconstruction mode. Methods.Various surgical approaches and types of surgical interventions have been used. Planning operations, as well as evaluating the radicality of tumor removal based on MRI, CT and endoscopic examination. Different methods of skull base reconstruction after craniofacial resection were investigated. Endoscopic assistance was used to control the reconstruction quality intra- and postoperatively. Results.A single-institution experience in the treatment of 240 patients with primary sinonasal malignancies with dural and brain involvement was performed. Tumor initial sites were nasal cavity, paranasal sinuses and nasopharynx. These tumors usually destruct anterior skull base and invade dura and brain tissue. We performed craniofacial resection in 28%, subtotal removal in 24% and biopsy in 48%. Complications of craniofacial resection and subtotal removal were pointed: nasal CSF leak (15%), infectious and inflammatory complications (10%), oculomotor and visual impairment (5%), autograft necrosis (5%), and anemia (20%). The mortality rate was 2%. The follow-up period was 4.5 years. Conclusion. Further research is needed to improve the results of complex treatment and reduce the incidence of postoperative complications in patients with malignant tumors of the skull base. There is a high risk of postoperative complications in cases of radical craniofacial resection.