title: Development of minimally invasive surgery for sinonasal malignancy.
abstract: Sinonasal malignancies are rare and histologically heterogeneous. Treatment is complicated by tumor aggressiveness and location near critical anatomic structures (orbita, skull base, etc.). This low incidence and histologic diversity make prospective studies unfeasible, and thus therapeutic guidelines difficult to establish. The gold standard for surgery is a transfacial approach, with craniofacial resection in case of skull-base involvement. However, these techniques are associated with non-negligible perioperative morbidity. In the past two decades, endoscopic surgery has made major progress, extending its indications: initially developed for functional sinus surgery, it is now applied in benign skull-base pathologies (CSF leakage, meningocele, etc.) and, more recently, in sinonasal malignancy. Literature analysis shows a significant decrease in morbidity and improved quality of life associated with endoscopic endonasal surgery, with oncologic safety and efficacy in well-selected cases, although dependent on operator experience. Additional studies with longer follow-up and comparison between histologic subtypes will be needed.
authors.affiliation: Département de cancérologie cervico-faciale, Institut Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France. Electronic address: antoinemoya@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Moya-Plana
authors.affiliation: Service de neurochirurgie, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Bresson
authors.affiliation: Département de cancérologie cervico-faciale, Institut Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
authors.forename: S
authors.initials: S
authors.lastname: Temam
authors.affiliation: Département de chirurgie plastique et reconstructrice, Institut Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
authors.forename: F
authors.initials: F
authors.lastname: Kolb
authors.affiliation: Département de cancérologie cervico-faciale, Institut Gustave-Roussy, 114, rue Edouard-Vaillant, 94800 Villejuif, France.
authors.forename: F
authors.initials: F
authors.lastname: Janot
authors.affiliation: Service de chirurgie ORL et cervico-faciale, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Herman
mesh_terms: D004724:Endoscopy / Q000379:methods*; D006488:Hemostasis, Surgical; D006801:Humans; D053783:Magnetic Resonance Imaging, Interventional; D009669:Nose Neoplasms / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D018579:Patient Selection; D015641:Radiography, Interventional
keywords: Endoscopic surgery; Sinonasal malignancy; Skull-base surgery; Transfacial approach