Endoscopic resection of sinonasal adenocarcinomas

Rev Laryngol Otol Rhinol (Bord). 2009;130(4-5):255-9.

Abstract

Objective: To evaluate the outcome and morbidity of endoscopic resection of sinonasal adenocarcinomas.

Methods: This is a case series of 17 patients diagnosed with sinonasal adenocarcinoma that were resected endoscopically between 1999 and 2008.

Results: The surgery constituted the first line of treatment for all patients. Five anterior skull base reconstructions were done. Post-operative meningoencephalitis and minimal epistaxis were the complications reported. The mean follow-up was 3 years [6-107 months]. To date, there have been two local recurrences at 6 months of an insufficient resection of a tumour classified pT4 and 25 months of a pT2 resected with safe margins. Another patient presented an unique metastasis in the parietal lobe 42 months after the resection of tumour pT4 extended to the frontal lobe. Two deaths unrelated to the disease were reported while thirteen patients remained free of disease (76.5%).

Conclusion: The endoscopic approach is a safe and effective treatment in selected cases of sinonasal adenocarcinomas. This procedure is less invasive than conventional surgery but requires an optimal preoperative imaging protocol and an experienced surgical team. These encouraging results have to be confirmed by a larger cohort and a longer follow-up.

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopy*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Paranasal Sinus Neoplasms / mortality
  • Paranasal Sinus Neoplasms / surgery*
  • Postoperative Complications