The nurse's role as clinical coordinator for the Center for Cranial Base Surgery.

The newly created position of clinical coordinator for the Center for Cranial Base Surgery at Presbyterian-University Hospital is detailed in this article. The position evolved in response to needs of this specialized center, because the complexities of cranial base tumors (CBTs) require optimal patient care be a collaborative effort. The clinical coordinator works with the neurosurgeon in all phases of treatment. From the preoperative visit, through admission and surgery, and then in postoperative care and follow-up, patient care is centered not only on the physical aspects inherent in surgery and recovery, but also on psychological support and attention which must be maintained throughout the patient's treatment course. In addition, the clinical coordinator has important input concerning research activities, particularly in clinical implementation of new therapies, as well as patient data management. Inservice education of other health professionals in their dealings with CBT patients further enhances quality of and continuity in patient care. Patient-care responsibilities as well as related research and training activities are discussed.

Total temporal bone resection. A radical but life-saving procedure.

Traditional therapeutic approaches for malignancies of the temporal bone have produced unacceptably low survival figures. The morbidity and mortality associated with temporal bone cancer justify extensive surgery. Total temporal bone resection can be performed successfully in the hands of an experienced skull-base surgical team. By circumscribing the tumor rather than transgressing it, this procedure follows generally accepted principles of oncologic surgery. This procedure also shows promise in resection of extensive, carefully selected, recurrent benign tumors. We believe this approach offers hope for improved survival in patients with malignancy of the temporal bone. Further refinements in technique are suggested by each new case. Additional experience and long-term follow-up are needed to assess the efficacy of this procedure. The interest, expertise, and active participation of the operating room nursing team are critical to the success of this surgery. Ideally, not only intraoperative participation but also preoperative assessment and postoperative support should be routine. Close cooperation and extensive communication among the surgeons and nurses are essential.