Endoscopic Surgery in Malignant Rhinosinusal Tumors

Abstract

Background: In this study, we describe our experience in the treatment of malignant rhinosinusal tumors and establish factors related to their prognosis.Objectives: To determine the local control and the survival rates in patients with malignant tumors of the paranasal sinuses and nasal cavity treated by endonasal endoscopic surgery. Design: Descriptive and prospective.Methods: All patients who had malignant tumors of the nasal cavity and paranasal sinuses who were treated by an endonasal, cranionasal or combined endonasal an external approach in the ENT Department of the Italian Hospital of Buenos Aires from March 2003 to August 2019 were selected. Patient data were collected prospectively and updated by reviewing electronic medical records.Results: Thirty patients were treated, 10 had tumors located in the nasal cavity. No patient had local recurrence.Twenty had malignant tumors originated in the paranasal sinuses. Twelve endonasal approaches were performed with endoscopes only, 9 had adjuvant treatment with radiotherapy and chemoradiotherapy. The local control rate was 50% (6/12). Six cranionasal approaches were made: All had adjuvant treatment with radiotherapy or chemoradiotherapy and two others were treated by an endonasal and external approach, and postoperative radiation therapy.The local control rate in patients treated with cranionasal and combined approaches was 75%. Conclusions:The rate of local control and survival that we obtained in patients treated for rhinosinusal malignant tumors by endonasal endoscopic surgery was 73.33%.Tumors with greater extension and infiltration, with higher T staging, localization in the paranasal sinuses and unfavorable histologies such as undifferentiated carcinoma, had a greater need for neoadjuvant or adjuvant treatment and worse prognosis than those small, T1-2, and localized neoplasms in the nasal cavity.