[Rescue operations of the recurrent nasal and paranasal sinus neoplasms]

To investigate the symptoms, factors relating to recurrences, the styles of the rescue operation and the reconstructive methods of the surgical defects in patients with recurrent nasal and paranasal sinus neoplasms.

Excluding the primary neoplasm, only patients with recurrent tumors and suitable for rescue operations entered the group. Kaplan-Meier method was used to estimate the survival probability.

Twenty-five patients receiving rescue operations from 1993 to 2002 who met the above inclusion criteria were reviewed. The age ranged from 13 - 66 years. All the patients had once surgery or radiation therapy at least. The time between the last treatments and the recurrences ranged from 2 weeks to 46 months. 80 per cent of the recurrences were within the first 2 years after the last therapy. The recurrent symptoms included headache (10 patients), eminences in or around the operation fields (9 patients), diminution of vision (7 patients), and so on. The patients were followed 1 to 65 months. There were no patients died during the rescue operations. Five patients were alive without recurrences and 3 alive with local or regional recurrences. Thirteen died of local recurrences and 1 died of metastasis to lung. The one-year, 2-year and 3-year survival rate were 62.5%, 43.7% and 29.1%, respectively. The median survival time was 18 months. Complications included cerebrospinal rhinorrhea (3 patients), central diabetes insipidus (1 patient) and necrosis of part of the flap (1 patient).

Most of the local recurrences occur within 2 years after the last therapies. The recurrent symptoms are commonly headache and eminences in or around the operation fields. The recurrences are closely related to pathological types and differential degrees of the neoplasms. The reasonable and timely combined treatment may help to decrease the frequencies of the recurrences. The rescue operations with effective methods can improved the patients' life qualities and lengthen their life spans. The main complications are cerebrospinal rhinorrhea most of which can be cured by conservative treatment.