title: Removal of sinonasal tumors by the endonasal endoscopic approach.
abstract: BACKGROUND
  The external approach is the golden standard for sinonasal tumor removal but is associated with several side effects, including facial scars, intracranial and extracranial complications, a long hospitalization period and high costs. Endoscopic sinus surgery enables resection of benign and selected malignant sinonasal tumors and has the advantages of no facial scars, better functional and structural preservation of the sinonasal complex, minimal trauma to surrounding tissue, a shorter hospitalization stay and lower costs.
  
  
  OBJECTIVE
  To evaluate the advantages and limitations of endoscopic resection of benign and malignant sinonasal tumors, their recurrence and complication rates.
  
  
  METHODS
  The medical and radiology records of 56 patients who underwent endonasal endoscopic resection of benign and malignant sinonasal tumors between 1996 and 2003 were retrospectively reviewed. Tumors located in the center of the nose and sinuses were endoscopically resected.
  
  
  RESULTS
  Six cases of malignant tumor and 50 cases of benign tumor underwent resection by ESS. One of the patients with malignant tumor died, the remainder showing no evidence of disease on follow-up of 3-60 months (mean 26.8 months). Inverted papilloma was the most common benign tumor (40 patients). Seven patients (18%) had recurrence followed by endonasal resection. No major complications were recorded. Hospitalization stay was 2-7 days (mean 3.6 days).
  
  
  CONCLUSIONS
  Endoscopic resection of benign sinonasal tumors that are centrally located in the nose and sinuses should be considered before the external approach is used. In very carefully selected cases of malignant tumors ESS is oncologically acceptable, but more experience is needed for discerning the indications for endoscopic resection of malignant tumors. The complication rate for endoscopic resection is low, there are no facial scars, hospitalization stay is short, and costs are low.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, Assaf Harofeh Medical Center, Zerifin, Israel. eviatar@asaf.health.gov.il
authors.forename: Ephraim
authors.initials: E
authors.lastname: Eviatar
authors.forename: Michael
authors.initials: M
authors.lastname: Vaiman
authors.forename: Nathan
authors.initials: N
authors.lastname: Shlamkovitch
authors.forename: Samuel
authors.initials: S
authors.lastname: Segal
authors.forename: Alex
authors.initials: A
authors.lastname: Kessler
authors.forename: Udi
authors.initials: U
authors.lastname: Katzenell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009669:Nose Neoplasms / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D018579:Patient Selection; D012189:Retrospective Studies; D016896:Treatment Outcome