Surgical outcomes of malignant sinonasal tumours: open versus endoscopic surgical approaches

Saedi, Babak; Aghili, Mahdi; Motiee, Maziar; Valadkhani, S; Niazi, Ammar; Safavi, Amin

doi:10.1017/s0022215114001583

Cited by 27 publications

(29 citation statements)

References 26 publications

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“…Commonly accepted surgical limits of endoscopic surgery include extension to orbital content, facial soft tissue, palate and areas beyond the reach of current optics and instrumentation. When carefully selecting patients, endoscopic sinus surgery for sinonasal malignancy has similar results compared to open surgery in terms of recurrence and overall survival 33,34 . Open approaches range from Caldwell-Luc to lateral rhinotomies, maxillectomies and anterior craniofacial resections with increasing functional and aesthetic deficits.…”

Section: Sinonasalmentioning

confidence: 99%

Difficulties in the surgical management of head and neck cancer patient

Sarafoleanu

Vuzitas

Manea

2017

Romanian Journal of Rhinology

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Malignancies of the upper aerodigestive tract are high morbidity bearing and life-threatening diseases, which require thorough care from diagnostic suspicion and confirmation to surgical and/or oncologic treatment and rehabilitation. Difficulties in managing head and neck cancers arise from delays in diagnosis and treatment caused by either patient-related factors or healthcare system-related factors. Tumor origin and stage determine whether surgical excision is feasible, the approach required for safe excision, the extent of functional and aesthetic sacrifice required to attain oncologic safety and the need for reconstructive surgery. A thorough and systematic preoperative risk versus benefits assessment to select potential surgical candidates and give realistic outcomes is important from both a medical and a legal point of view. Because tumors in the head and neck region frequently involve more than one system and sensory organ, potential loss of function from either the disease course, surgical or nonsurgical treatment should be taken into account form a quality of life perspective. Effective management of head and neck cancer patients requires the cooperation and combined effort of a multidisciplinary team of surgeons, physicians and other workers over a long period of time which, in the absence of a specialised head and neck cancer centre and guidelines, can lead to increased morbidity and mortality, and patient dissatisfaction.

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Section: Sinonasalmentioning

confidence: 99%

Difficulties in the surgical management of head and neck cancer patient

Sarafoleanu

Vuzitas

Manea

2017

Romanian Journal of Rhinology

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“…Surgical management of SNSCC can be either open or endoscopic, with open resection being more common. Recent studies indicate that advances in endoscopic surgery have made surgical resection of SNSCC safer and less invasive without sacrificing oncologic outcomes …”

Section: Introductionmentioning

confidence: 99%

Margins in Sinonasal Squamous Cell Carcinoma: Predictors, Outcomes, and the Endoscopic Approach

Torabi

Spock²,

Cardoso

et al. 2019

The Laryngoscope

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Objectives: To identify factors associated with positive margins following surgical management of sinonasal squamous cell carcinoma (SNSCC), especially with regard to endoscopic treatment.Methods: In a retrospective analysis of adult patients with clinically staged tumor (T)1 to T4a SNSCC within the National Cancer Database (NCDB) from 2004 to 2014, factors were associated with positive margins using multivariable binary logistic regression. Cases from 2010 to 2014 had surgical approach (open vs. endoscopic) available and were analyzed in a subgroup to assess the association of surgical approach with margin status. The association of margin status with overall survival (OS) and additional therapy administration was also assessed.Results: We identified 2,968 cases, of which 807 (27.2%) had positive margins. On multivariable analysis, factors associated with positive margins included higher T stage (T4a vs. T1: odds ratio [OR] 2.768 [95% CI 2.143-3.577]), less differentiated tumors (poorly differentiated vs. well differentiated: OR 1.403 [95% CI 1.060-1.856]), and tumors in the ethmoid sinus (vs. nasal cavity; OR 1.889 [95% CI 1.305-2.734]). Cases treated at higher volume facilities (HVFs) were associated with a lower likelihood of positive margins (OR 0.716 [95% CI 0.582-0.881]). Positive margins were associated with decreased OS (hazard ratio 1.672 [95% CI 1.464-1.908]) and an increased rate of additional therapy (OR 1.966 [95% confidence interval 1.597-2.421]). An endoscopic approach was not associated with an increased likelihood of obtaining positive margins (vs. open; OR 1.151 [0.903-1.651]).Conclusion: Positive margins were less likely when performed at HVFs and more likely in the ethmoid sinus than other subsites. Importantly, there was no association between positive margins and surgical approach. Endoscopic surgery may offer a safe, less invasive alternative to open surgery for select patients.

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“…EESBS offers many advantages over traditional open approaches. It avoids brain retraction, provides more direct midline exposure, results in less manipulation of neurovascular structures, improves visualization, and provides the ability to surveil the patient postoperatively with similar or superior oncologic results . EESBS approaches provide shorter length of stay, less operating time, reduced morbidity, reduced local recurrence rates, and improved quality of life compared to open approaches …”

Section: Resultsmentioning

confidence: 99%

Robotic surgery of the anterior skull base

Campbell

2019

Int Forum Allergy Rhinol

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Background: Significant advances have been made in transoral robotic surgery (TORS), yet its application in anterior skull-base surgery has yet to be defined. This work explores the history of endoscopic sinus and anterior skullbase surgery, and its advantages and disadvantages. The development of robotic surgery is then discussed as well as the advantages and disadvantages of TORS as it relates to the anterior skull base. The current applications for robotic surgery to the anterior skull base are presented with details of future applications. Methods:A structured search of the current literature using MEDLINE, PubMed, and EMBASE was performed from inception to May 2019. Search terms related to topics of robotic skull-base surgery were identified and queried to identify relevant articles. Results:Fi y-four papers were identified from the literature search and a hand search of the references. Twentyone other references were discovered from personal communication, websites, and books relevant to the topic. Conclusion:Anterior skull-base surgery has the potential for significant morbidity compared to head and neck surgery, yet the application of the robot in sinus and anterior skull-base surgery has yet to be formally defined. Currently, there are certain limitations that need to be overcome; however, research to address these barriers is currently underway and promises an exciting future for robotic sinus and anterior skull-base surgery. C 2019 ARS-AAOA, LLC.

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Surgical outcomes of malignant sinonasal tumours: open versus endoscopic surgical approaches

Abstract: Endoscopic surgery for sinonasal malignancies is comparable to the conventional open approach in carefully selected patients.

Cited by 27 publications

References 26 publications

Difficulties in the surgical management of head and neck cancer patient

Difficulties in the surgical management of head and neck cancer patient

Margins in Sinonasal Squamous Cell Carcinoma: Predictors, Outcomes, and the Endoscopic Approach

Robotic surgery of the anterior skull base

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