Craniofacial Resection for T4 Maxillary Sinus Carcinoma

Nishio, Naoki; Fujimoto, Yasushi; Fujii, Masazumi; Saito, Kiyoshi; Hiramatsu, Masayuki; Mutoh, T.; Iwami, Kenichiro; Kamei, Yuzuru; Yagi, Shunjiro; Takahashi, Masakatsu; Hayashi, Yuichiro; Ando, Atsushi; Nakashima, Tsutomu

doi:10.1177/0194599815586770

Cited by 26 publications

(22 citation statements)

References 36 publications

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“…The distribution of histological diagnoses in our study is in accordance with the available literature, identifying SCC, AC and ONB as the three most common pathologies treated by open CFR, followed by SA, MA, ACC and SNUC, representing a significantly smaller proportion of cases [6,4,40,5,19,17,48,28,12,2,1,35,7,39,43].…”

Section: Discussionsupporting

confidence: 89%

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Craniofacial resection of malignant tumors of the anterior skull base: a case series and a systematic review

et al. 2018

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Background: Craniofacial resection (CFR) is still considered as the gold standard for managing sinonasal malignancies of the anterior skull base (ASB), while endoscopic approaches are gaining credibility. The goal of this study was to evaluate outcomes of patients who underwent CFR at our institution and to compare our results to international literature. Method: Retrospective analysis of all patients undergoing CFR between 1995 and 2017, and systematic literature review according to the PRISMA statement. Results: 41 patients with sinonasal malignancy (81% with stage T4) of the ASB were included. There was no operative mortality. Complications were observed in 9 cases. We obtained 100% follow-up with mean observation 100 months. Disease-specific survival rates were 90%, 74% and 62% and recurrence-free survival was 85% at two, 72% at five and ten years follow-up, respectively. CFR as primary treatment, en bloc resection, and resection with negative margins correlated to better survival. Recursive partition analysis identified the latter as the most important prognostic factor, regardless surgical technique. The relative risk of non-radicality was significantly higher after piecemeal resection compared to en bloc resection. Compared to 15 original articles, totaling 2603 patients, eligible for review, the present study has the longest follow-up time, the second highest 5year OS and the third highest 5-year DSS, despite having a higher proportion of patients with high-stage disease. Conclusion: CFR in true en bloc fashion can still be considered as the treatment of choice in cases of advancedstage sinonasal malignancies invading the ASB.

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Section: Discussionsupporting

confidence: 89%

“…retrospective case series [6,4,5,19,17,48,28,12,2,7,1,35,39,43] and one international collaborative study [40] were eligible for further review, totaling 2603 patients (1296 and 1307, respectively) ( Figure 1).…”

Section: Systematic Literature Reviewmentioning

confidence: 99%

Craniofacial resection of malignant tumors of the anterior skull base: a case series and a systematic review

et al. 2018

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“…Almost half of resections had involved margins, which in turn did not imply a significant worsening of prognosis. The absence of a measurable impact on outcomes, which contrasts with other published series [48,49], might be caused by histological heterogeneity and other confounders such as the systematic use of defect-driven frozen-sections and, when indicated, additional specimens. In fact, when uninvolved additional specimens were not clearly orientable with respect to a positive margin on the main specimen, the margin status was considered as involved on a precautional basis, thus possibly leading to overestimation of margin infiltration.…”

Section: Discussionmentioning

confidence: 64%

Malignant tumors of the maxillary sinus: Prognostic impact of neurovascular invasion in a series of 138 patients

et al. 2020

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Background: Maxillary sinus cancer is a rare disease with heterogeneous biologic behavior. The pattern of neurovascular invasion is known to be an important prognosticator in head and neck cancers, but has not been studied in maxillary malignancies. Materials and methods: Patients undergoing surgery-based treatment with curative intent for a malignancy of the maxillary sinus at the Unit of Otorhinolaryngology-Head and Neck Surgery of the University of Brescia between November 2000 and October 2018 were included. A description of the characteristics of the patients, tumors, and treatments has been performed along with uni-and multi-variate analysis of prognostic factors. Tumors were classified based on the presence of perineural (P 0 /P 1) and lymphovascular invasion (V 0 /V 1

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“…Tumor was resected using en bloc craniofacial resection with a Weber-Ferguson incision and an anterolateral craniofacial approach. 7 Tensor fasciae latae was used for the dura defect when direct suturing was impossible. Plastic surgeons reconstructed the oncologic resected defect using a free rectus abdominis musculocutaneous flap.…”

Section: Methodsmentioning

confidence: 99%

“…Wide en bloc resection and craniofacial reconstruction using a free flap is the mainstay of maxillary sinus carcinoma treatment. 7 Maxillary sinus carcinoma often invades the surrounding tissue including the orbit, nasal cavity, hard palate, and cranial base. 8 It is necessary to reconstruct the barrier between the cranial base and nasal and/or oral cavity to protect the central nervous system and to restore the facial contour aesthetically, which requires a large amount of soft tissue.…”

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confidence: 99%

Relationship between BMI and Postoperative Complications with Free Flap in Anterolateral Craniofacial Reconstruction

Heo

Yagi

Toriyama

et al. 2016

Plastic and Reconstructive Surgery - Global Open

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Background:Although we have seen tremendous advancement in microsurgery over the last 2 decades and free tissue transfer has become standard for head and neck reconstruction, surgeons still struggle to prevent postoperative complications. We examined the relationship between body mass index (BMI) and postoperative complications in patients undergoing rectus abdominis free flap transfer after anterolateral craniofacial resection.Methods:This was a retrospective review of reconstructive surgery using rectus abdominis musculocutaneous free flap in patients with locally advanced maxillary sinus carcinoma from 2003 to 2014 (n = 35, 27 men and 8 women; average age, 60.9 ± 7.8 years). All patients underwent craniofacial reconstruction after anterior and middle cranial fossa skull base resection and maxillectomy (class IV, subtype a) with palatal resection. Patients were categorized based on sex, BMI, and other parameters.Results:Recipient-site infection occurred in 11 patients (31.4%), cerebrospinal fluid leakage in 6 (17.1%), partial flap necrosis in 2 (5.7%), total flap necrosis in 1 (2.9%), and facial fistula in 4 (11.4%). Women showed partial flap necrosis significantly more frequently (P = 0.047), probably owing to poor vascular supply of the subcutaneous fat layer. Patients with low BMI (<20 kg/m2) showed recipient-site infection (P = 0.02) and facial fistula (P = 0.01) significantly more frequently owing to insufficient tissue volume and poor vascular supply.Conclusion:Postoperative recipient-site infection and facial fistula occurred mainly in low-BMI patients. Surgeons should take care to achieve sufficient donor tissue on low-BMI patients. Using a prosthetic obturator in low-BMI patients for craniofacial reconstruction can be a good alternative option to reduce postoperative complications due to insufficient donor tissue volume.

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Craniofacial Resection for T4 Maxillary Sinus Carcinoma

Cited by 26 publications

References 36 publications

Craniofacial resection of malignant tumors of the anterior skull base: a case series and a systematic review

Craniofacial resection of malignant tumors of the anterior skull base: a case series and a systematic review

Malignant tumors of the maxillary sinus: Prognostic impact of neurovascular invasion in a series of 138 patients

Relationship between BMI and Postoperative Complications with Free Flap in Anterolateral Craniofacial Reconstruction

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