Rigid endoscopy in minimally invasive therapy of tumours of the paranasal sinuses and skull base

Abstract

The use of rigid endoscopes in paranasal sinuses, nasopharynx and skull base surgery has extended and diversified, specifically for the treatment of malignant lesions of the nose and paranasal sinuses. We have endoscopically treated 33 patients with tumours of the skull base, paranasal sinuses and nasopharynx during the last 8 years (five patients with juvenile nasopharyngeal angiofibromas and 28 patients with various malignant tumours and T-classification). Endoscopic tumour surgery can be performed in patients of all age groups, even in the first days of life, using endoscopes of different diameters. Cosmetic results are excellent; there is no disfiguration of the face. Functional results are also excellent in terms of: organ preservation, minimal morbidity and rapid postoperative recovery and short hospitalisation. All these factors are essential for the patient's quality of life. Limitations of this technique, however, are found at the anatomical borders of the paranasal sinuses, when a tumour extensively infiltrates the orbit, the surrounding soft-tissue and skull base. However, very aggressive and extensive endoscopic surgery can be performed, e.g. removal of bone and dura of the anterior skull base, as well as resection of the periorbit and lateral nasal wall with the turbinates. Our results, with only a few recurrences after endoscopic endonasal tumour surgery, encourage us to use this procedure in selected cases as a reliable alternative to other techniques.

Endoscopic resection of esthesioneuroblastoma

“…24 This single center study from the Medical University in Graz, Austria, which builds on the authors' prior reports, 9,22,25,26 described 14 patients with esthesioneuroblastoma. Twelve patients had newly diagnosed disease and two had previously undergone surgery.…”

“…[9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] To our knowledge, Folbe et al is the largest series reported. 16 This was a combined series from the University of Pittsburgh Medical Center and the University of Miami Miller School of Medicine and builds on the authors' previous experience.…”

Endonasal Approach for Nasal and Paranasal Sinus Tumor Removal

“…Combining technical advances of instrumentation, imaging, and interventional radiology, angiofibromas stage 1 and 2 seem to be suitable for endonasal removal [10,17,18]. This was also experienced in our study.…”

“…Growing experience has led to extending indications for endonasal approaches of benign and malignant tumors [1,[5][6][7][8][9][10]. The aim of our study was to detail our experience with various tumors.…”

“…Shah et al [22] reported an endoscopic sphenoethmoidectomy for well-differentiated adenocarcinoma. Anderhuber et al [10] treated 28 malignant tumors of various histologies successfully via the endonasal route.…”