title: [Total ethmoidectomy using the mixed rhinoneurosurgical approach for malignant tumors of the anterior skull base. 14 years' experience. 62 cases].
abstract: Based on 62 cases, the authors report on 14 years of experience of total ethmoidectomies through a mixed rhinological and neurosurgical approach. Following a survey of the main points of the surgical technique, they emphasize the major evolution undergone, on the one hand, by the preoperative topographic diagnostic possibilities thanks to progress in imaging, and, on the other hand, the operative technique itself. The optimization of the reconstruction time for the base of the skull seems to provide a substantial advantage by reducing morbidity and operative mortality. The use of the epicranial flaps and to a lesser degree, cryo-stored bone allografts are the major stages. Prognostically speaking, the mixed approach offers a clear improvement in the 5-year survival rate of adenocarcinomas (80%), and olfactory placode tumors. However, the prognosis for epidermoid carcinomas continues to be poor (35% at 5 years) due to the frequency of local recurrences and visceral metastases.
authors.affiliation: C.H.U. Pellegrin Tripode, Clinique ORL, Bordeaux.
authors.forename: J P
authors.initials: JP
authors.lastname: Bébéar
authors.forename: D
authors.initials: D
authors.lastname: Stoll
authors.forename: V
authors.initials: V
authors.lastname: Darrouzet
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery*; D005004:Ethmoid Bone / Q000601:surgery; D006801:Humans; D009362:Neoplasm Metastasis / Q000473:pathology; D012189:Retrospective Studies; D012888:Skull Neoplasms / Q000401:mortality / Q000601:surgery*
vernacular_title: L'ethmoïdectomie totale par voie mixte rhino-neurochirurgicale pour les tumeurs malignes de l'étage antérieur--14 ans d'expérience--62 cas.