title: Combined transfacial and neurosurgical approach to malignant tumours of the ethmoid sinus.
abstract: In order to understand the risks and benefits of a combined transfacial and neurosurgical procedure for neoplasms of the ethmoid sinus, we reviewed all patients who underwent this surgical approach in our department between 1986 and 1994. The study included 41 patients. Pathological diagnoses included adenocarcinoma (31 patients), squamous cell carcinoma (three patients), aesthesioneuroblastoma (three patients), other (four patients). The overall morbidity rate was 39 per cent, and the post-operative mortality rate was 2.5 per cent. Complications were statistically more likely in patients with bone skull base reconstruction. The main carcinologic failures were local recurrences (24 per cent) and metastases (22 per cent). The one-year, three-year and five-year Kaplan Meir survival rates were respectively 84 per cent, 53 per cent and 36 per cent. In conclusion, the mortality and morbidity were acceptable, especially when no bone skull base reconstruction was performed. Better local control justifies a combined procedure with post-operative radiotherapy when tumours involve or reach the skull base.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Institute Gustave Roussy, Villejuif, France.
authors.forename: D
authors.initials: D
authors.lastname: Salvan
authors.forename: M
authors.initials: M
authors.lastname: Julieron
authors.forename: P
authors.initials: P
authors.lastname: Marandas
authors.forename: F
authors.initials: F
authors.lastname: Janot
authors.forename: A M
authors.initials: AM
authors.lastname: Leridant
authors.forename: C
authors.initials: C
authors.lastname: Domenge
authors.forename: G
authors.initials: G
authors.lastname: Mamelle
authors.forename: G
authors.initials: G
authors.lastname: Schwaab
authors.forename: B
authors.initials: B
authors.lastname: Luboinski
mesh_terms: D000230:Adenocarcinoma / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D005005:Ethmoid Sinus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D019635:Neurosurgical Procedures / Q000379:methods; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D015996:Survival Rate