title: Endoscopic endonasal surgery for malignancies of the anterior cranial base.
abstract: OBJECTIVE
  Data from several centers worldwide have demonstrated that transnasal endoscopic surgery performed with or without a transcranial approach is capable of achieving radical resection of selected sinonasal malignancies. We report our experience with endoscopic management of sinonasal cancers, with emphasis on naso-ethmoidal malignancies encroaching on the anterior skull base.
  
  
  METHODS
  Major series reporting results concerning the endoscopic endonasal approach with or without craniectomy for treatment of sinonasal and anterior skull base cancers were reviewed. Preoperative work-up, indications and exclusion criteria, surgical techniques, postoperative management, and adjuvant therapy are reported.
  
  
  RESULTS
  In the 2 largest series analyzed, the most common malignancies were adenocarcinoma (28%), olfactory neuroblastoma (14.5%), and squamous cell carcinoma (13.5%). The 5-year disease-specific survival rate ranged from 81.9%-87%, with no major differences in the mean follow-up time (34.1 months vs. 37 months).
  
  
  CONCLUSIONS
  Endoscopic endonasal resection performed with or without a transcranial approach, when properly planned and in expert hands, has an accepted role with precise indications in the surgeon's armamentarium for the treatment of sinonasal and skull base malignancies.
authors.affiliation: Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Castelnuovo
authors.affiliation: Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy. Electronic address: mail.paolobattaglia@gmail.com.
authors.forename: Paolo
authors.initials: P
authors.lastname: Battaglia
authors.affiliation: Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Turri-Zanoni
authors.affiliation: Department of Neurosurgery, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.
authors.forename: Giustino
authors.initials: G
authors.lastname: Tomei
authors.affiliation: Department of Neurosurgery, Civic Hospital of Legnano, Legnano, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Locatelli
authors.affiliation: Department of Otorhinolaryngology, Ospedale di Circolo e Fondazione Macchi, University of Insubria, Varese, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bignami
authors.affiliation: Department of Otorhinolaryngology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy.
authors.forename: Andrea Bolzoni
authors.initials: AB
authors.lastname: Villaret
authors.affiliation: Department of Otorhinolaryngology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Nicolai
mesh_terms: D000328:Adult; D000368:Aged; D059186:Chemoradiotherapy, Adjuvant; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D011182:Postoperative Care; D019651:Plastic Surgery Procedures; D019291:Skull Base / Q000601:surgery; D019292:Skull Base Neoplasms / Q000175:diagnosis / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Cranio-endoscopic approach; Craniofacial resection; Endoscopic endonasal approach; Sinonasal cancers; Skull base reconstruction; Skull base surgery