Endoscopic Endonasal Surgery for Malignancies of the Anterior Cranial Base
Endoscopic Endonasal Surgery for Malignancies of the Anterior Cranial Base
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DOI：
10.1016/j.wneu.2014.07.021
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发表时间：
2014-12-01
影响因子：
2
通讯作者：
Nicolai, Piero
中科院分区：
文献类型：
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作者：
Castelnuovo, Paolo;Battaglia, Paolo;Nicolai, Piero
目的：来自全球多个中心的数据表明，无论是否采用经颅入路进行经鼻内窥镜手术，都能够实现选定鼻窦恶性肿瘤的根治性切除。我们报告我们的经验，鼻内镜下鼻窦癌的管理，重点是鼻筛窦恶性肿瘤侵犯前skilbase.METHODS：主要系列报道结果有关的内窥镜鼻内镜下入路或不开颅术治疗鼻窦和前颅底癌进行了审查。术前检查，适应症和排除标准，手术技术，术后管理和辅助治疗reported.RESULTS：在2个最大的系列分析，最常见的恶性肿瘤是腺癌（28%），嗅神经母细胞瘤（14.5%），鳞状细胞癌（13.5%）。5年疾病特异性生存率范围为81.9%-87%，平均随访时间无重大差异（34.1个月vs. 37个月）。如果计划得当并由专家操作，具有公认的作用，在外科医生治疗鼻窦和颅底恶性肿瘤的设备中具有精确的适应症。
OBJECTIVE: Data from several centers worldwide have demonstrated that transnasal endoscopic surgery performed with or without a transcranial approach is capable of achieving radical resection of selected sinonasal malignancies. We report our experience with endoscopic management of sinonasal cancers, with emphasis on naso-ethmoidal malignancies encroaching on the anterior skull base.METHODS: Major series reporting results concerning the endoscopic endonasal approach with or without craniectomy for treatment of sinonasal and anterior skull base cancers were reviewed. Preoperative work-up, indications and exclusion criteria, surgical techniques, postoperative management, and adjuvant therapy are reported.RESULTS: In the 2 largest series analyzed, the most common malignancies were adenocarcinoma (28%), olfactory neuroblastoma (14.5%), and squamous cell carcinoma (13.5%). The 5-year disease-specific survival rate ranged from 81.9%-87%, with no major differences in the mean follow-up time (34.1 months vs. 37 months).CONCLUSIONS: Endoscopic endonasal resection performed with or without a transcranial approach, when properly planned and in expert hands, has an accepted role with precise indications in the surgeon's armamentarium for the treatment of sinonasal and skull base malignancies.