Abstract
Objective: This study reviewed the surgical technique of endoscopic resection with transnasal craniectomy (ERTC), its indications, and morbidity in the management of selected sinonasal malignancies.
Method: From April 1996 to December 2010, 265 patients affected by sinonasal malignant tumors were treated by endoscopic resection at 2 referral university hospitals. From 2004, 126 patients underwent ERTC. Duraplasty was carried out using iliotibial tract and fat tissue. Overall (O), disease-specific (DS), and recurrence-free (RF) survival were calculated.
Results: The most frequent histologies were adenocarcinoma (57%) and olfactory neuroblastoma (16%). Eighty-seven (69%) patients were previously untreated. The overall complication rate was 10.6%. Cerebrospinal fluid leak was observed in 9 (7%) cases. The mean hospitalization time was 10.5 days (range, 5-32 days). Overall, 75 (60%) patients received adjuvant treatment. After a mean follow-up of 52.7 months (range, 12-169 months), 100 (79.3%) patients had no evidence of disease, with 5-year OS, DSS, and RFS of 82.6%, 85.7%, and 77.9% respectively.
Conclusion: ERTC is a safe procedure with an acceptable complication rate, allowing the ability to perform a wide resection of the dura with a correct assessment of its involvement. Only a few cases of malignancies extending intracranially require combining with an external subfrontal craniotomy.
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