Endoscopic endonasal technique: treatment of paranasal and anterior skull base malignancies

Kasemsiri, Pornthep; Prevedello, Daniel M.; Otto, Bradley A.; Old, Matthew; Filho, Leo F. Ditzel; Kassam, Amin; Carrau, Ricardo L.

doi:10.5935/1808-8694.20130138

Cited by 24 publications

(18 citation statements)

References 120 publications

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“…The advantages of endoscopic approaches are better cosmetic outcome, avoidance of scarring and facial incisions, avoidance of maxillofacial skeletal dissection and translocation. In addition, endoscopic approaches allow better visualization of some deep areas within the sinonasal region that are out of sight in the open approaches through the use of an angled lenses which allow better visual access to these areas …”

Section: Discussionmentioning

confidence: 99%

Endoscopic resection of sinonasal malignancies

Abdelmeguid

Raza

et al. 2019

Head & Neck

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Background In this study, we evaluate our experience and the outcomes of patients with sinonasal cancer treated with endoscopic resection. Methods Retrospective review of patients with sinonasal cancer who had endoscopic resection was conducted. The outcomes of interest included survival outcomes and surgical complications. Results Overall, 239 patients were included. Median follow up time was 46.6 months. Of the 239 patients, 167 (70%) had a pure endonasal endoscopic approach, while 72 (30%) had an endoscopic‐assisted approach. Postoperative cerebrospinal fluid (CSF) leakage occurred in 14 patients (5.9%). Negative margins were achieved in 209 patients (87.4%). There was no significant difference in the margin status between the pure endoscopic and endoscopic‐assisted group (P = .682). There was no significant difference in the survival outcomes between both the groups. Conclusion Our data suggest that in properly selected patients, endoscopic approaches have acceptable morbidity with low complication rates and can provide an oncologically sound alterative to open approaches.

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Section: Discussionmentioning

confidence: 99%

Endoscopic resection of sinonasal malignancies

Abdelmeguid

Raza

et al. 2019

Head & Neck

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“…2,20 Although traditional craniofacial resection remains the gold standard, several recent studies have suggested that EEA and CEA are oncologically sound in appropriately selected patients, 8,9 and have equivalent or reduced postoperative complications. [21][22][23] In the present study, we characterize our cranial base center's evolution regarding endoscopic skull base surgery, as well as the outcomes achieved with various surgical approaches.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have suggested that size, location, and the presence of nearby neurovascular structures should be considered in planning an endonasal approach. 10,23,35 We suggest an algorithm for approach to the anterior skull base in ►Fig. 3.…”

Section: Discussionmentioning

confidence: 99%

“…Involvement of the nasal bones, anterior table of the frontal sinus, or skin overlying the nasal dorsum or frontal sinus, and frank involvement of the eye (requiring exenteration) are better treated with a traditional open approach that incorporates a transfacial incision. 23,34 Next, the surgeon should consider the extent of intracranial extension. In patients with superficial tissue involvement requiring a transfacial incision, any involvement of the brain parenchyma should be approached with a craniotomy; a transfacial incision only may be done if there is no intracranial component.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have suggested that extension lateral to the midorbital plane be considered the boundary of what is resectable endoscopically. 23 Lastly, reconstruction must be considered, as anterior skull base resection can result in a large dural defect. We use a pedicled nasoseptal flap for the majority of our endoscopic reconstructions, particularly if adjuvant therapy is planned; if this tissue is not available (due to tumor involvement or previous resection), we prefer craniotomy for layered reconstruction with a pericranial flap.…”

Section: Discussionmentioning

confidence: 99%

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An Algorithm for Surgical Approach to the Anterior Skull Base

et al. 2016

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Objective?To characterize our experience with the surgical management of anterior skull base malignancy, and to propose an algorithm for surgical approach to anterior skull base malignancies. Design?Retrospective review. Setting?Academic cranial base center. Participants?Sixty-seven patients who underwent resection of paranasal sinus or anterior skull base malignancy with an endoscopic, cranioendoscopic, or traditional anterior craniofacial approach. Outcome Measures?Complications, recurrence, and survival. Results?There were 48 males and 19 females, ranging from 6 to 88 years old. There were three groups: endonasal endoscopic resection (n?=?10), cranioendoscopic resection (n?=?12), and traditional craniofacial resection (n?=?45). The most common tumor pathologies included esthesioneuroblastoma, squamous cell carcinoma, and sinonasal undifferentiated carcinoma. Patients with T3/T4 disease were less likely to undergo endoscopic resection (p?=?0.007). The 5-year disease-free survival was 82.1% overall, with no statistically significant differences among approaches. There were no differences in orbital complications, meningitis, or cerebrospinal fluid leak. Use of a transfacial incisions predisposed patients to surgical site infection and sinocutaneous fistulae. An algorithm for surgical approach was developed based on these results. Conclusion?Sinonasal and skull base malignancies can be safely surgically addressed via several approaches. Surgical approach should be selected algorithmically based on preoperative clinical assessment of the tumor and known postoperative complication rates.

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International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

Kuan

Wang

Adappa

et al. 2024

Int Forum Allergy Rhinol

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BackgroundSinonasal neoplasms, whether benign and malignant, pose a significant challenge to clinicians and represents a model area for multidisciplinary collaboration in order to optimize patient care. The International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors (ICSNT) aims to summarize the best available evidence and presents 48 thematic and histopathology‐based topics spanning the field.MethodsIn accordance with prior ICAR documents, ICSNT assigned each topic as an Evidence‐Based Review with Recommendations, Evidence‐Based Review, and Literature Review based on level of evidence. An international group of multidisciplinary author teams were assembled for the topic reviews using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses format, and completed sections underwent a thorough and iterative consensus‐building process. The final document underwent rigorous synthesis and review prior to publication.ResultsThe ICNST document consists of 4 major sections: general principles, benign neoplasms and lesions, malignant neoplasms, and quality of life and surveillance. It covers 48 conceptual and/or histopathology‐based topics relevant to sinonasal neoplasms and masses. Topics with a high level of evidence provided specific recommendations, while other areas summarized the current state of evidence. A final section highlights research opportunities and future directions, contributing to advancing knowledge and community intervention.ConclusionAs an embodiment of the multidisciplinary and collaborative model of care in sinonasal neoplasms and masses, ICSNT was designed as a comprehensive, international, and multidisciplinary collaborative endeavor. Its primary objective is to summarize the existing evidence in the field of sinonasal neoplasms and masses.This article is protected by copyright. All rights reserved

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Endoscopic endonasal technique: treatment of paranasal and anterior skull base malignancies

Cited by 24 publications

References 120 publications

Endoscopic resection of sinonasal malignancies

Endoscopic resection of sinonasal malignancies

An Algorithm for Surgical Approach to the Anterior Skull Base

International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

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