Abstract
Objectives: Prospective analysis of risk factors for and case experience with neoplasms of nasal cavities and/or ethmoid sinuses over an 11-year period, a follow-up series to Osguthorpe and Weisman in 1991 (Arch Otolaryngol Head Neck Surg 117:751-756). Methods: Prospective analysis of 59 patients treated for nasal/ethmoid neoplasms with minimun follow-up of 18 months and median of 43 months. Results: Risk factors for paranasal neoplasia identified 25 patients with tobacco use, 8 with chemical, 5 with heavy metal, and 13 with organic fiber work-related exposures. Primary therapy was en bloc surgical extirpation, supplemented by irradiation in aggressive malignancies. None of the 27 with inverting papillomas (13 referred for recurrences, 7 with co-existing carcinomas) has recurred, except for 1 with brain invasion treated palliatively with chemoradiation. None of the 5 with esthesioneuroblastomas but 3 of 4 with sinonasal undifferentiated carcinomas (SNUC) had disease recurrence. The surgical approaches and experiences with the remaining patients will be detailed. Conclusions: En bloc extirpation is very effective for treating benign and low grade malignancies of the nasal cavities and ethmoid sinuses, but postoperative irradiation seems prudent for more aggressive malignancies. Optimal treatment for SNUC has yet to be determined.
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