Background: We introduce a new concept in treatment of esthesioneuroblastomas, developed in the University Medical School of Graz, Austria.
Patients and methods: Six patients suffering from esthesioneuroblastoma have been treated in the years 1993-1999; five of them with a curative aspect, one with a palliative one. Three tumours were classified according to Kadish as stage B, three as stage C. The selection criteria included tumours without deep infiltration into the orbit nor into the pterygopalatine fossa and without any involvement of the posterior wall of the frontal sinus. The treatment consists of endoscopic nasal and paranasal sinus surgery and consecutive stereotactic radiosurgery by means of the Gamma-Knife unit.
Results: Over an average follow-up period of 38 months all patients remained free of disease. Because of the minimally invasive character of our concept the complications and side effects are minimised and the patients are less traumatised in comparison to conventional treatment such as craniofacial resection or irradiation.
Conclusion: Due to the excellent outcome of our six patients we recommend this new treatment concept, in selected cases, as an alternative to the usual therapeutic modalities for esthesioneuroblastoma.