Artikel
The role of endonasal endoscopic surgery in the treatment of sinonasal malignant tumours
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Veröffentlicht: | 22. Juli 2009 |
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Gliederung
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Background: Endonasal endoscopic surgery (EES) gains increasing importance in the treatment of sinonasal solid malignant tumours (SN-TM).
Methods: Retrospectively, we assessed the therapeutic strategies for patients suffering from SN-TM who were treated in our hospital from May 2003 to May 2008. The role of EES was analysed.
Results: Thirty-eight patients (23♂, 15♀, average-age: 69 y.) with SN-TM were treated. Following histologies occurred: 18 x squamous cell carcinoma, 8 x adenoid cystic carcinoma, 4 x adenocarcinoma, 3 x malignant melanoma, 2 x chordoma, 3 x other carcinoma. In 25 cases (66%) histology was obtained by means of EES in general anaesthesia, in 13 cases (34%) by means of biopsy in local anaesthesia. Thirty-four patients (89%) were operated. Surgical treatment was performed as EES (17 patients, 45%), lateral rhinotomy (9 patients, 32%), midfacial degloving (7 patients, 25%) or as combined neurosurgical-rhinosurgical approach (2 patients, 7%). Four patients (11%) underwent palliative radiochemotherapy. Therapy decision was made considering location and extension of the primary tumour, onset of metastases and general health conditions of the patient. From 17 patients who received EES 9 operations were carried out under a curable and 8 under a palliative point of view. Navigation was used in all EES procedures. Up to now 17 patients have died, 7 of them after EES.
Conclusions: Meanwhile EES gained an important position in diagnosis and therapy of sinonasal malignancies. In two thirds of our patients it was used to obtain their histology and one third of our patients underwent EES for surgical therapy.