Endoscopic Versus Traditional Craniofacial Resection for Patients with Sinonasal Tumors Involving the Anterior Skull Base
2
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Objectives. With the advent of microdebriders and image guidance systems, endoscope-assisted surgery is now more widely used for the treatment of tumors involving the base of the skull. The aim of this study was to analyze the clinical features of tumors involving the anterior skull base and to evaluate the treatment outcomes according to the surgical approach, which included the traditional craniofacial resection (TCFR) and the endoscopic craniofacial resection with craniotomy (ECFR). Methods. Forty-six patients who underwent craniofacial resection from 1989 through 2006 at Seoul National University Hospital and Seoul National University Bundang Hospital were included in this study. Demographics, histology, surgical management, surgical outcomes, complications, and morbidity were analyzed. Results. The number of malignant and benign lesions was 40 and 6 cases respectively. The most common diagnosis was olfactory neuroblastoma occurring in 41% of the cases followed by squamous cell carcinoma and malignant melanoma. Thirty-six patients underwent TCFR, while ECFR was performed with or without adjunctive chemotherapy or radiotherapy in 10 patients. The overall five-year survival rate for patients with malignant tumors of the anterior skull base was 47.4%. Out of 19 patients with olfactory neuroblastomas, 10 patients had TCFR and six among them died of their disease. Nine patients underwent ECFR, and none of them died of their disease. The ECFR group had lower morbidity and cosmetic deformity than did the TCFR group. Conclusion. The ECFR may be considered as an alternative option for the treatment of selected tumors with anterior skull base invasion. This approach offers the advantages of avoiding facial incisions with comparable treatment results.
Abstract
Objectives. With the advent of microdebriders and image guidance systems, endoscope-assisted surgery is now more widely used for the treatment of tumors involving the base of the skull. The aim of this study was to analyze the clinical features of tumors involving the anterior skull base and to evaluate the treatment outcomes according to the surgical approach, which included the traditional craniofacial resection (TCFR) and the endoscopic craniofacial resection with craniotomy (ECFR). Methods. Forty-six patients who underwent craniofacial resection from 1989 through 2006 at Seoul National University Hospital and Seoul National University Bundang Hospital were included in this study. Demographics, histology, surgical management, surgical outcomes, complications, and morbidity were analyzed. Results. The number of malignant and benign lesions was 40 and 6 cases respectively. The most common diagnosis was olfactory neuroblastoma occurring in 41% of the cases followed by squamous cell carcinoma and malignant melanoma. Thirty-six patients underwent TCFR, while ECFR was performed with or without adjunctive chemotherapy or radiotherapy in 10 patients. The overall five-year survival rate for patients with malignant tumors of the anterior skull base was 47.4%. Out of 19 patients with olfactory neuroblastomas, 10 patients had TCFR and six among them died of their disease. Nine patients underwent ECFR, and none of them died of their disease. The ECFR group had lower morbidity and cosmetic deformity than did the TCFR group. Conclusion. The ECFR may be considered as an alternative option for the treatment of selected tumors with anterior skull base invasion. This approach offers the advantages of avoiding facial incisions with comparable treatment results.
참고문헌 (24)
- Buchmann L, "Endoscopic techniques in resection of anterior skull base", paranasal sinus malignancies, 200, pp.116(10), 1749~1754
- Ketcham AS, "A combined intracranial facial approach to the paranasal sinuses", Am J Surg, 106, pp.678~703 (1963)
- Kraus DH, "Complications of craniofacial resection for tumors involving the anterior skull base", Head Neck, 16(4), pp.307~312 (1994)
- Richtsmeier WJ, "Complications and early outcome of anterior craniofacial resection", Arch Otolaryngol Head Neck Surg, 118(9), pp.913~917 (1992)
- Yuen AP, "Endoscopic cranionasal resection of anterior skull base tumor", Am J Otolaryngol, 18(6), pp.431~433 (1997)
- Thaler ER, "Endoscopically assisted anterior cranial skull base resection of sinonasal tumors", Am J Rhinol, 13(4), pp.303~310 (1999)
- Devaiah AK, "Esthesioneuroblastoma: endoscopic nasal and anterior craniotomy resection", Laryngoscope, 113(12), pp.2086~2090 (2003)
- Castelnuovo PG, "Endoscopic nasal and anterior craniotomy resection for malignant nasoethmoid tumors involving the anterior skull base", Skull Base, 16(1), pp.15~18 (2006)
- Lund V, "Endoscopic resection of malignant tumors of the nose and sinuses", Am J Rhinol, 21(1), pp.89~94 (2007)
- Lee CH, "Anterior and middle skull base surgery: SNUH Experience", Korean J Otolaryngol- Head Neck Surg, 4(2), pp.218~225 (1998)
- Har-El G, "Endoscopic management of anterior skull base tumors", Otolaryngol Clin North Am, 38(1), pp.133~144 (2005)
- Rhee CS, "Adenoid cystic carcinoma of the sinonasal tract: treatment results", Laryngoscope, 116(6), pp.982~986 (2006)
- Osguthorpe JD, "Craniofacial approaches to tumors of the anterior skull base", Otolaryngol Clin North Am, 34(6), pp.1123~1142 (2001)
- Cheesman AD, "Craniofacial resection for tumors of the nasal cavity and paranasal sinuses", Head Neck Surg, 8(6), pp.429~435 (1986)
- Shah JP, "Craniofacial resections for tumors involving the base of the skull", Am J Surg, 154(4), pp.352~358 (1987)
- Levine PA, "The craniofacial resection-eleven-year experience at the University of Virginia: problems and solutions", Otolaryngol Head Neck Surg, 101(6), pp.665~669 (1989)
- Lund VJ, "Craniofacial resection for tumors of the nasal cavity and paranasal sinuses", Am J Surg, 156(3pt1), pp.187~190 (1988)
- McCutcheon IE, "Anterior transcranial (craniofacial) resection of tumors of the paranasal sinuses: surgical technique and results", Neurosurgery, 38(3), pp.471~479 (1996)
- Bockmuhl U, "Endonasal micro-endoscopic tumor surgery: state of the art", Laryngorhinootologie, 84(12), pp.884~891 (2005)
- Roh HJ, "Endoscopic resection of sinonasal malignancies: a preliminary report", Am J Rhinol, 18(4), pp.239~246 (2004)
- Oskouian RJ Jr, "Sheehan JM, Laurent JJ, Levine PA. Esthesioneuroblastoma: clinical presentation, radiological, and pathological features, treatment, review of the literature, and the University of Virginia experience", Neurosurg Focus, (12)통권 : 5 (2002)
- Kim DW, "Neoadjuvant etoposide, ifosfamide, and cisplatin for the treatment of olfactory neuroblastoma", Cancer, 101(10), pp.2257~2260 (2004)
- Simon JH, "Esthesioneuroblastoma: the University of Iowa experience 1978-1998", Laryngoscope, 111(3), pp.488~493 (2001)
- Polin RS, "The role of preoperative adjuvant treatment in the management of esthesioneuroblastoma: the University of Virginia experience", Neurosurgery, 42(5), pp.1029~1037 (1998)