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Outcome and analysis of the surgical management of esthesioneuroblastoma
J Irish1, R Dasgupta, J Freeman
1Department of Otolaryngology/Head and Neck Program, Princess Margaret Hospital; University of Toronto Faculty of Medicine, Ontario.
Objective:
The aim of this study was to evaluate the effectiveness of combined radical surgical resection and radiotherapy for the treatment of esthesioneuroblastoma, a rare malignant neoplasm accounting for 1 to 5% of malignant neoplasms of the nasal cavity.
Method:
A 10-year review of 12 patients treated at our institution suggests that primary treatment consisting of a combined otolaryngologic/neurosurgical craniofacial approach results in good local control with relatively low morbidity and complication. Patients tend to present with advanced stage disease because of the nonspecific presenting signs and symptoms. Eighty-three percent of the patients were treated with combined surgery and radiation.
Results:
Seventy-five percent of the patients are free of disease with an average follow-up time of 54 months. Based on our experience in anterior skull base surgery (zone I), we strongly advocate the pericranial flap for dural reconstruction. Postoperative complications occurred in 25% of the cases with no postoperative deaths.
Conclusion:
Failure analysis suggests that radical surgical resection combined with radiotherapy provides the best chance of disease control.