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  • Title: [Trans-cranio-naso-orbital approach in treatment of ethmoid sinus malignant tumors: analysis of 39 cases].
    Author: Zhang TM, Fang JG, Chen XH, Zhang JL, Li Y, Zhao JW.
    Journal: Zhonghua Yi Xue Za Zhi; 2007 Jan 30; 87(5):304-7. PubMed ID: 17456356.
    Abstract:
    OBJECTIVE: To summarize the experience in treatment of ethmoid sinus malignant tumors via trans-cranio-naso-orbital approach. Post-operationally follow-up was conducted in 27 cases for 3.5 years (3 months to 7 years). METHODS: The clinical data of 39 patients with ethmoid sinus malignant tumors, 25 males and 14 females, aged 42 (20 - 65), with the chief complaints of nasal airway obstruction, rhinorrhagia, nasal neoplasm, exophthalmos, decreased vision, facial numbness, disturbance of consciousness, etc, who underwent resection of tumor via trans-cranio-naso-orbital approach retrospectively. Pre-operational MR showed that the tumor invaded the anterior cranial fossa in 38 cases, invading the orbit in 31 cases, invaded the pterygopalatine fossa in 5 cases, invaded the middle cranial fossa and cavernous sinus in 3 cases. RESULTS: Tumor total removal was achieved in 32 cases (including removal en bloc in 9 cases), and subtotal removal in 7 cases. Pathological examination diagnosed 10 cases as with olfactory neuroblastoma, 8 cases with adenocarcinoma, 7 cases with squamous cell carcinoma, 6 cases with pallima carcinoma, 4 cases with unclassified sarcoma, 3 cases with undifferentiated carcinoma, and 1 case with schneiderian carcinoma. Postoperatively, temporal CSF leak was found in 5 cases. There was no intracranial or wound infection. Local recurrence was found in 8 cases, 1 case had lung metastasis, and 4 cases died 1 month to 6 years postoperatively. CONCLUSION: Adequate exposure of the ethmoid sinus tumor involving the anterior cranial fossa and orbit can be obtained via suitable trans-cranio-naso-orbital approach, and by this approach the tumor can be removed en bloc. This approach is relatively safe and with few complications.
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