Endoscopic v/s conventional approach to sino-nasal tumours — What’s the debate?

Abstract

In the past two decades nasal endoscopy has advanced technologically to offer us magnified vision and better illumination along with better instrumentation. Surgery has traditionally been via the transfacial approaches such as lateral rhinotomy or the Weber Fergueson incision. For disease extension into the skull base traditional approach is a transfrontal craniotomy via either the bicoronal incision or the subcranial Raveh's approach. A combined access via the cranium from above and the transfacial access from below aids in encompassing the tumour all around. Transnasal access is a natural trajectory which leads us directly onto the tumour. The endoscope alone or with the microscope has been utilised to improve the magnification and illumination to aid in tumour removal. Minimal access to the Sinonasal and anterior skull base tumours is proven to be possible and feasible. We now have an additional armamentarium to our existing approaches in management of these tumours. We have to be judicious and see which approach can remove the disease completely maintaining the quality of life of the patient.