Neuroectodermal Tumours

Endonasal anatomy of the olfactory neural network: Surgical implications

“…Our observation that 20% of the olfactory fila at the septum cross to the contralateral side, raises questions about current methods to manage tumors such as olfactory neuroblastoma, a tumor that, in theory, may originate anywhere throughout the distribution of olfactory neuroepithelium and spread along olfactory fila . This finding may suggest that in some patients with unilateral tumors extending to the septum, it may not be adequate to preserve the contralateral septal mucoperiosteum even when clinically and radiographically clear.…”

“…Our observation that 20% of the olfactory fila at the septum cross to the contralateral side, raises questions about current methods to manage tumors such as olfactory neuroblastoma, a tumor that, in theory, may originate anywhere throughout the distribution of olfactory neuroepithelium [10][11][12][13][14][15] and spread along olfactory fila. [16][17][18] This finding may suggest that in some patients with unilateral tumors extending to the septum, it may not be adequate to preserve the contralateral septal mucoperiosteum even when clinically and radiographically clear. In addition, this suggests that olfactory neuroblastoma with intracranial invasion may exhibit perineural spread bilaterally; thus, questioning whether patients with intradural tumors, even if limited to one side, should still be considered candidates for a unilateral resection (i.e., preservation of the contralateral olfactory nerve and bulb).…”