Chirurgie des tumeurs sinusiennes

Abstract

The surgical treatment of tumours of the nasal cavity and paranasal sinuses has been improved this last decade by some innovations in imaging techniques. Recent imaging techniques (CT-Scan and MRI) are the best diagnostic tools and are crucial when selecting the therapeutic strategy. Endoscopic surgery of paranasal sinuses has become the procedure of choice for benign tumours of the nasal cavity and paranasal sinuses. How the concept of endonasal surgical treatment can be applied to a malignant tumour and in particular to an ethmoidal adenocarcinoma? Lateral rhinotomy for ethmoidal adenocarcinoma allows removing the lateral mass of the ethmoidal bone and preserving the walls of the lateral masses. Endoscopic surgery outcomes are of the same quality than carcinologic results. Transfacial approach may be necessary when tumour extends to the surrounding structures. Nose and paranasal sinuses tumours can be successfully treated by endonasal approach. Traditional lateral rhinotomy approach of nasosinusal cavities remains the standard therapy for malignant tumours. If the tumour is very small-sized and located within the ethmoid sinuses, an endoscopic approach may be considered. Improvements may be expected from new advances in computer assisted surgery.