Clin Exp Otorhinolaryngol.  2008 Sep;1(3):148-153. 10.3342/ceo.2008.1.3.148.

Endoscopic Versus Traditional Craniofacial Resection for Patients with Sinonasal Tumors Involving the Anterior Skull Base

• Kim BJ
• Kim DW
• Kim SW
• Han DH
• Kim DY
• Rhee CS
• Lee CH

• KMID: 1486085
• DOI: http://doi.org/10.3342/ceo.2008.1.3.148

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.

Keyword

Nose neoplasms; Skull base; Endoscopic craniofacial resection

MeSH Terms

Carcinoma, Squamous Cell
Congenital Abnormalities
Cosmetics
Craniotomy
Demography
Esthesioneuroblastoma, Olfactory
Humans
Melanoma
Nose Neoplasms
Skull
Skull Base
Survival Rate
Cosmetics

Figure

• 

  Fig. 1 Comparison in morbidity between surgical approaches using the Mann-Whitney U test. ECFR group shows shortened hospital stay and operation time compared with TCFR group. ECFR: endoscopic craniofacial resection with craniotomy; TCFR: traditional craniofacial resection.

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