[Trans-cranio-naso-orbital approach in treatment of ethmoid sinus malignant tumors: analysis of 39 cases].
OBJECTIVE
To summarize the experience in treatment of ethmoid sinus malignant tumors via trans-cranio-naso-orbital approach. Post-operationally follow-up was conducted in 27 cases for 3.5 years (3 months to 7 years).


METHODS
The clinical data of 39 patients with ethmoid sinus malignant tumors, 25 males and 14 females, aged 42 (20 - 65), with the chief complaints of nasal airway obstruction, rhinorrhagia, nasal neoplasm, exophthalmos, decreased vision, facial numbness, disturbance of consciousness, etc, who underwent resection of tumor via trans-cranio-naso-orbital approach retrospectively. Pre-operational MR showed that the tumor invaded the anterior cranial fossa in 38 cases, invading the orbit in 31 cases, invaded the pterygopalatine fossa in 5 cases, invaded the middle cranial fossa and cavernous sinus in 3 cases.


RESULTS
Tumor total removal was achieved in 32 cases (including removal en bloc in 9 cases), and subtotal removal in 7 cases. Pathological examination diagnosed 10 cases as with olfactory neuroblastoma, 8 cases with adenocarcinoma, 7 cases with squamous cell carcinoma, 6 cases with pallima carcinoma, 4 cases with unclassified sarcoma, 3 cases with undifferentiated carcinoma, and 1 case with schneiderian carcinoma. Postoperatively, temporal CSF leak was found in 5 cases. There was no intracranial or wound infection. Local recurrence was found in 8 cases, 1 case had lung metastasis, and 4 cases died 1 month to 6 years postoperatively.


CONCLUSIONS
Adequate exposure of the ethmoid sinus tumor involving the anterior cranial fossa and orbit can be obtained via suitable trans-cranio-naso-orbital approach, and by this approach the tumor can be removed en bloc. This approach is relatively safe and with few complications.
Zhang
Tian-ming
TM
Department of Neurosurgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Fang
Ju-gao
JG
Chen
Xiao-hong
XH
Zhang
Jia-liang
JL
Li
Yong
Y
Zhao
Jing-wu
JW
D000328:Adult; D000368:Aged; D003399:Craniotomy / Q000379:methods*; D005005:Ethmoid Sinus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D019291:Skull Base / Q000601:surgery