Endoscopic techniques in resection of anterior skull base/paranasal sinus malignancies.
OBJECTIVE
The objective of this study was to examine the role of endoscopic approaches to the resection of anterior skull base and paranasal sinus malignancies at one tertiary care medical center.


METHODS
The authors conducted a retrospective chart review over a period of 17 years.


METHODS
Patients undergoing anterior skull base resections for malignancies over a 17-year period were reviewed. Data were collected on each patient with respect to the pathology of the tumor and approach used as well as demographic and follow-up information.


RESULTS
A total of 78 patients were treated at a tertiary care medical center for malignancies of the paranasal sinuses and anterior skull base. The most common diagnosis was squamous cell carcinoma occurring in 33% of the cases. The remaining pathologies included esthesioneuroblastoma (23%), adenoid cystic carcinoma (15%), melanoma (3%), sinonasal undifferentiated carcinoma (3%), lymphoma (5%), nasopharyngeal carcinoma (4%), and other tumor types (14%). Endoscopic techniques were used extensively in this population of patients. Combined approaches using a sublabial/transmaxillary approach and coronal approaches were used when indicated and complemented the endoscopic approach. A majority of patients were without evidence of disease at the end of this review. Using endoscopic techniques allowed for acceptable cosmetic results and facial incisions were used minimally.


CONCLUSIONS
With complete endoscopic surgical resection followed by radiation therapy, local recurrence, morbidity, and cosmetic deformity have been minimized. The microscopic view provided by endoscopic techniques, with or without complementary approaches, allows for complete tumor removal.
Buchmann
Luke
L
Department of Otolaryngology Head and Neck Surgery, University of Kansas Medical Center, Kansas City, Kansas, USA. lbuchmann@kumc.edu
Larsen
Christopher
C
Pollack
Ania
A
Tawfik
Ossama
O
Sykes
Kevin
K
Hoover
Larry A
LA
D002277:Carcinoma / Q000601:surgery; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D018572:Disease-Free Survival; D004724:Endoscopy / Q000379:methods*; D018304:Esthesioneuroblastoma, Olfactory / Q000601:surgery; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008223:Lymphoma / Q000601:surgery; D008297:Male; D008437:Maxilla / Q000601:surgery; D008545:Melanoma / Q000601:surgery; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000601:surgery; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000628:therapy; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery*; D015996:Survival Rate