Surgery with Post-Operative Endoscopy Improves Recurrence Detection in Sinonasal Malignancies

Area of Science:

• Otolaryngology
• Surgical Oncology
• Head and Neck Cancer Research

Background:

• Sinonasal malignancy (SNM) treatment primarily relies on surgery, often combined with chemoradiation for optimal prognosis.
• Post-treatment surveillance for SNM includes physical examination, radiologic evaluation, and nasal endoscopy.

Purpose of the Study:

• To evaluate the role of nasal endoscopy in detecting tumor recurrence after surgery for sinonasal malignancy.
• To assess the impact of surgically patent sinus cavities on the early detection of recurrent SNM.

Main Methods:

• Retrospective chart review of patients with pathologically proven SNM from 2005 to 2019.
• Analysis of recurrence detection methods, including nasal endoscopy, imaging, and physical examination.

Main Results:

• Local recurrence was the most common pattern of disease recurrence in SNM.
• Nasal endoscopy identified 50% of local recurrences, with many occurring within surgically patent paranasal sinuses.
• Squamous cell carcinoma was the most frequent pathology, and the median time to recurrence was 9.8 months.

Conclusions:

• Nasal endoscopy is crucial for detecting local recurrence of sinonasal malignancy.
• Open sinus cavities resulting from surgery facilitate the detection of tumor recurrence within the paranasal sinuses.
• Surgical intervention in SNM management offers an advantage in surveillance and early detection of recurrence.