DIFFERENT MODALITIES FOR THE TREATMENT OF NASO-ETHMOIDAL TUMORS INVOLVING THE ANTERIOR SKULL BASE

Abstract

Background: opened Craniofacial resection has been considered the gold standard in the management of malignancies involving the anterior skull base(ASB). In recent years, there has been growing enthusiasm for purely endoscopic techniques for craniofacial malignancies. Aim of the work: To evaluate the modalities in the management of nasoethmoidal tumors invading the (ASB). Patients and methods: The study was carried out on ten patients with naso-ethmoidal tumors invading the (ASB). The patients were classified into two groups; group(A) and group(B). Group (A) included five patients were subjected to traditional craniofacial resection (TCFR) and group (B) included five patients who had endoscopic craniofacial resection (ECFR). Postoperative radiotherapy or chemo radiotherapy was planned according to the tumor pathology and staging . The follow up period ranged from 12 to 30 months Results: The most common presenting symptoms of the patients were nasal obstruction, epistaxis and proptosis. The commonest histopathological findings of the tumor were olfactory neuroblastoma, squamous cell carcinoma. In group (A) the post operative complications were encountered in two patients in the form of wound infection and C.N.S complications while In group (B) the post operative complications were encountered in one patient in the form of C.S.F leak. In group(A), three patients had a complete tumor eradication and one patient had a local recurrence while in group (B),three patients had a complete eradication of the tumor and two patients had a local recurrence. There was one case of mortality in group (A). Conclusion: ECFR may reduce the surgery related morbidity and mortality. However, it has a higher local recurrence rate when compared to that of TCFR outcome. It should be considered as an alternative treatment option for selected sinonasal tumors involving the (ASB).
Keywords: anterior skull base, craniofacial resection, malignancies