Surgical treatment of adenoid cystic carcinomas of sinonasal localization

Abstract

Background. Tumors of the sinonasal region represent a large group of both benign and malignant formations affecting the nasal cavity, paranasal sinuses, structures of the anterior and middle cranial pits of the base of the skull.Aim. Evaluation of the results of surgical treatment of patients with adenoid cystic carcinomas of sinonasal localization treated in the period from 2007 to 2021.Material and methods. The present study is a retrospective analysis of the results of surgical treatment of patients with adenoid cystic cancer of the base of the skull operated at the N.N. Burdenko National Medical Research Center of Neurosurgery in the period from 2007 to 2021.Results. The radicality of tumor removal was assessed based on an MRI analysis performed no earlier than 3 months after surgery. Total (95–100 %) tumor removal was achieved in 8 (25 %), subtotal (80–95 %) in 15 (46.9 %), partial (50–80 %) in 5 (15.6 %) patients; extended biopsy was performed in 4 (12.5 %) cases. At the same time, total and subtotal removal was more often achieved with open surgery, which was due to the topographic and anatomical features of the location of tumors.Discussion. In this paper, we present an analysis of the results of treatment of 32 patients with adenocystic cancer of sinonasal localization.The main method of treatment is an integrated approach – radical surgical resection of the tumor together with adjuvant radiation therapy. Surgical treatment is aimed at the maximum possible resection of pathological tissues to prevent recurrence of the disease.One of the most common approaches is transfacial with or without bifrontal craniotomy, which includes craniofacial resection.Conclusion. Adenoid cystic carcinoma is an aggressive malignant tumor that requires a comprehensive approach to treatment. Important factors that positively affect the results of treatment are the conduct of chemoradiation treatment and the age of patients, as well as the initial stage of the disease at which treatment was initiated, which necessitates strengthening dispensary monitoring and raising awareness of the population about the possibility of developing such diseases for timely access to a doctor.