E-Mail karger@karger.com Original Paper Audiol Neurotol 2014;19:12–21 DOI: 10.1159/000355701 Giant Cell Tumors of the Skull Base: Case Series and Current Concepts Sampath Chandra Prasad a Enrico Piccirillo a Amjad Nuseir d Giuliano Sequino a Giuseppe De Donato a Carlo Terenzio Paties b Mario Sanna a, c a Department of Otology and Skull Base Surgery, Gruppo Otologico, and b Department of Pathology, Piacenza Civil Hospital, Piacenza, and c Department of ENT, University of Chieti, Chieti, Italy; d Jordan University of Science and Technology, Irbid, Jordan resolution CT scan and MRI with gadolinium enhancement were done in all patients. Radiology showed involvement of the ITF and middle ear in 6 (85.71%) patients each, temporo- mandibular joint in 4 (57.14%) patients, invasions of the squamous part of the temporal bone, mastoid, MCF and greater wing of sphenoid in 3 (42.9%) patients each and the petrous bone in 2 (28.6%) patients. ITFA type B was applied as an approach for tumor removal in 5 (71.43%) patients, in- cluding a case where an additional MCF approach was em- ployed, and ITFA type D and the transmastoid approach were applied in 1 (14.3%) patient each. Total tumor removal and successful cure was achieved in 6 (85.71%) patients. Subtotal removal leading to recurrence and eventual mor- tality was the result in 1 (14.3%) patient. Conclusions: A thor- ough knowledge of the anatomy of the skull base and the various skull base approaches is necessary to tackle GCTs. ITFA type B and D combined with MCF approaches provide good exposure of the tumor with minimal postoperative se- quelae and good locoregional control. Recurrence due to ei- ther subtotal removal or suboptimal treatment may have di- sastrous consequences for the patient. © 2013 S. Karger AG, Basel Key Words Giant cell tumors · Temporal bone · Skull base · Infratemporal fossa approach · Middle cranial fossa · Posterior cranial fossa · Radiotherapy Abstract Objective: To study the clinical features, tumor characteris- tics and outcomes of giant cell tumors (GCTs) in the skull base based on long-term follow-up. We also report the larg- est series of GCTs in the temporal bone and the lateral skull base. Materials and Methods: A retrospective study was conducted of all GCTs managed at the Gruppo Otologico, a quaternary referral skull base institute, in Italy from 1993 to 2013. The clinical features, investigations, surgical manage- ment and follow-up were recorded. The surgical approaches used were infratemporal fossa approach (ITFA) type B and D and middle cranial fossa (MCF) approaches. Results and Ob- servations: A total of 7 patients with GCTs of the skull base were treated at our institution. The principal complaints were hearing loss reported in 6 (85.71%) patients, tinnitus in 5 (71.43%) and swelling in 3 (42.9%). Pure-tone audiometry showed conductive hearing loss in 5 (71.43%) patients. High- Received: June 25, 2013 Accepted after revision: September 16, 2013 Published online: November 19, 2013 Neurotology Audiology Dr. Sampath Chandra Prasad, MS, DNB Department of Otology and Skull Base Surgery, Gruppo Otologico c/o Casa di Cura Privata ‘Piacenza’ spa Via Emmanueli 42, IT–29100 Piacenza (Italy) E-Mail sampathcp  @  yahoo.co.in © 2013 S. Karger AG, Basel 1420–3030/14/0191–0012$39.50/0 www.karger.com/aud Downloaded by: Verlag S. KARGER AG BASEL 172.16.7.47 - 11/22/2013 9:51:18 AM