Endoscopic Resection of Sinonasal Malignant Tumors

Woo, Hyun Jae; Bai, Chang Hoon; Song, Si Youn; Kim, Yong Dae

Abstract

BACKGROUND AND OBJECTIVES: Endoscopic surgery largely replaced the traditional external approach in the treatment of sinonasal inflammatory diseases and most benign tumors. However, there is much debate about its applicability to resection of sinosal malignancy. In this study, we demonstrate the efficacy of the endonasal endoscopic approach in the treatment of highly selected sinonasal malignant tumors.
SUBJECTS AND METHOD
We retrospectively reviewed the medical records and radiologic findings of 11 patients who had underwent transnasal endoscopic excision for sinonasal malignancy from 1998 to 2003. All patients were treated with curative intent.
RESULTS
The mean age was 60.6 (31-75 years) years and the mean follow-up period was 69 months (52-112 months). Eight cases consisted of T1 and three cases were T2. The pathologic diagnosis was malignant melanoma (4 cases), plasmacytoma (2 cases), adenoid cystic carcinoma, olfactory neuroblastoma, cylindrical cell carcinoma, squamous cell carcinoma and neuroendocrine carcinoma. In ten cases, the tumor was removed by transnasal endoscopic excision with adequate free margin of normal mucosa. In one case, Caldwell-Luc operation was combined with the endoscopic excision. During the follow-up, only one case of malignant melanoma had recurred at the lateral neck and retropharyngeal lymph node, but the other ten cases have kept up well without recurrence of primary tumor and significant complication.
CONCLUSION
Considering oncological results and surgery-related morbidities, transnasal endoscopic resection can be used as a good modality in the highly selected early T stage of sinonasal malignancies.