[Esthesioneuroblastoma. Transcribiform-transfovea ethmoidalis endonasal expanded approach. Technical note].
BACKGROUND
We report a fully endoscopic transcribiform-transfovea ethmoidalis endonasal expanded approach (EEA) for the treatment of esthesioneuroblastoma and review the literature about this entity available in English, establishing a precise surgical technique and describing our intraoperative experience.


METHODS
Our patient was a 65-year old female with anosmia and cognitive deterioration. Cranial MRI showed a large tumoral lesion with solid and cystic components involving the nasal cavity, with diagnostic suspicion of intracranial malignant sinonasal tumour. The patient underwent a fully endoscopic transcribiform-transfovea ethmoidalis EEA, achieving total resection and tumour-free margins. Surgery was followed by radiotherapy.


CONCLUSIONS
Craniofacial resection enables total removal of sinonasal malignancies, even when the intracranial cavity is involved, and allows for subarachnoid space isolation from the nasal cavity. New advances in endoscopic skull base surgery have achieved comparable oncological results and sufficient reconstructive capacity, leading to less morbidity and better tolerance.


CONCLUSIONS
EEA may become the first treatment option for skull base malignancies in an immediate future, provided that the anatomical limits of the extended approach are not exceeded by the lesion.
Servicio de Neurocirugía, Hospital Universitario y Politécnico La Fe, Valencia, España.
Juan Antonio
JA
Simal Julián
Pablo
P
Miranda Lloret
Eugenio
E
Cárdenas Ruiz-Valdepeñas
Agustín
A
Alamar Velásques
Andrés
A
Beltrán Giner
Carlos
C
Botella Asunción
D004724:Endoscopy; D018304:Esthesioneuroblastoma, Olfactory; D006801:Humans; D009296:Nasal Cavity; D009669:Nose Neoplasms; D019291:Skull Base / Q000601:surgery