Causes of Perioperative Death in Skull Base Surgery

At the University of California, Davis, Center for Skull Base Surgery between 1974 and January 2005 we have performed 205 operations for the resection of benign and malignant tumors that had both intracranial and extracranial extension. All pituitary and acoustic tumors are excluded from this series. There have been 9 deaths for a mortality rate of 4.1%. The most common causes of death were vascular, with the most frequent being injury to the internal carotid artery. The other causes were tension pneumocephalus, cerebral edema, infection, and pulmonary embolism. Pertinent case histories will be reviewed and preventative measures outlined.