title: [Combined transfacial and neurosurgical approach for the treatment of ethmoid cancers].
abstract: OBJECTIVE
  The purpose of this work was to examine the indications for the combined transfacial and neurosurgical approach to ethmoid cancers.
  
  
  METHODS
  Fifteen patients with ethmoid cancers underwent surgery via the combined approach between 1990 and 2000 at the Amiens University Hospital. The transfacial approach alone was reserved for elderly patients.
  
  
  RESULTS
  The histological diagnosis was adenocarcinoma in 10 patients. There was one postoperative death. Mean follow-up was 45 months (range 3 - 129). Six patients died from local or metastatic recurrence. At last follow-up eight patients were disease free, two had local or metastatic recurrence.
  
  
  CONCLUSIONS
  We compared systematic use of the combined approach for curative surgery with surgical strategies adopted by other teams. The combined approach is indicated for T3 or T4 tumors and for all other tumors with a posterior or superior extension. Anterior and unilateral tumors may be treated with the transfacial access alone. Limited tumors without extension to the orbit or cribiform plate may be managed endoscopically. The role of histological diagnosis and the choice of the surgical approach remain to be evaluated.
authors.affiliation: Service d'Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, Centre Hospitalo-Universitaire d'Amiens, pl. Victor Pauchet, 80054 Amiens Cedex 1.
authors.forename: L
authors.initials: L
authors.lastname: Michel
authors.forename: S
authors.initials: S
authors.lastname: Ayache
authors.forename: G
authors.initials: G
authors.lastname: Guillaume-Souaid
authors.forename: P
authors.initials: P
authors.lastname: Toussaint
authors.forename: D
authors.initials: D
authors.lastname: Le Gars
authors.forename: B
authors.initials: B
authors.lastname: Deschepper
authors.forename: D
authors.initials: D
authors.lastname: Chatelain
authors.forename: M F
authors.initials: MF
authors.lastname: Gontier-Calvet
authors.forename: V
authors.initials: V
authors.lastname: Strunski
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005005:Ethmoid Sinus / Q000528:radiation effects / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D019635:Neurosurgical Procedures / Q000379:methods*; D010255:Paranasal Sinus Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*
vernacular_title: Evaluation de la voie d'abord combinée transfaciale et neurochirurgicale dans le traitement des cancers de l'ethmoïde.