Endonasal Endoscopic Treatment of Esthesioneuroblastoma

Abstract

Introduction: Esthesioneuroblastoma is a malignant neoplasm that originates from the olfactory epithelium. Treatment is established according to its extension and the histological degree of atypia and may include surgery, surgery more radiotherapy or more chemoradiation therapy. Different surgical approaches have been used, including facial incisions and craniotomy, but with the greater experience acquired with endoscopic sinus surgery and teamwork with the neurosurgeon, endonasal techniques have been developed that make it possible to perform oncological resections in selected patients, with less morbidity, brief hospitalization and without compromising local control of the disease. Objectives: To determine the rate of local control in patients treated for esthesioneuroblastomas by the endonasal approach with endoscopes or through an endonasal approach with bifrontal craniotomy. Methods: A review of the electronic medical records of patients who were treated for esthesioneuroblastomas in the ENT Department of the Italiano Hospital of Buenos Aires between March 2005 and May 2022 was carried out. Results: Five patients were treated with an endonasal approach with endoscopes. Two patients with an endonasal approach only (Kadish B and C) and three with an endonasal approach combined with bifrontal craneotomy (Kadish C and one D). In four cases, chemotherapy-radiotherapy or radiotherapy was also used. Local control in the treated group was 80% (4/5) and specific survival was 60% (3/5). Conclusions: The local control that we obtained in patients treated for esthesioneuroblastomas through a single endonasal approach or combined with bifrontal craniotomy and adjuvant treatments was 80% and survival without local, regional or distant disease was 60%.