Abstract
Endoscopic techniques have made tremendous progress in recent years. This study reviews the outcome of patients with nasal and sinonasal malignancies treated by endoscopic surgery, according the same surgical principles as the open approach. Six patients received a purely endoscopic excision of nasal and sinonasal malignant tumors in our department between 2011 and 2013. Primary tumors arose from ethmoid sinuses in four cases, septum in one and nasal cavity in one case. One, four and one patient were classified as T1, T2 and T4a, respectively. There was neither lymph node metastasis nor distant metastasis. Pathological examination included three squamous cell carcinomas, one adenocarcinoma, one malignant melanoma and one teratocarcinosarcoma. Four patients received preoperative treatment, such as chemoradiation therapy, carbon ion radiotherapy and chemotherapy in two, two and one case, respectively.
All patients were alive without evidence of the disease or significant complications after surgery. In four patients, the tumors were extirpated involving the anterior skull base, however, no cerebrospinal fluid leaks were observed postoperatively. The anterior skull base was reconstructed with fat, fascia and nasoseptal flap in a multilayer fashion.
In conclusion, endoscopic surgery seems to offer a satisfactory alternative to external procedures in carefully selected patients with nasal and sinonasal malignancies. Further studies with a larger number of cases and longer follow-up are needed to validate the reproducibility and efficacy of the technique.
