Abstract
Objective It is important to characterize the developing complication profile of the open approach
as it becomes reserved for more complex disease during the endoscopic era. Our objective
was to characterize complication rates of current open skull base surgery.
Design Retrospective chart review.
Setting Tertiary care center.
Participants The study group consisted of 103 patients and 117 open skull base surgeries were
performed from 2008 to 2012.
Main Outcome Measures Intraoperative/postoperative complications.
Methods Fisher exact test and Wilcoxon rank sum test evaluated for associations of complications
with potential risk factors.
Results Postoperative complications occurred in 53 (45%) cases, of which 36 (31%) were major
complications. Malignancy, dural grafting, age, and obesity were not associated with
complications. Flap reconstruction was associated with increased complication rates
(odds ratio = 2.27; 95% confidence interval: 1.03–5.04).
Conclusion The open approach is increasingly utilized for only the most complex lesions, and
selection bias cannot be overstated in comparative series. This study suggests that
current open complication rates may be above those cited from prior studies, and patient
and physician expectations should be adjusted accordingly.
Keywords
open approach - skull base - complications
