Endonasal micro-endoscopic treatment of the malignant tumors of paranasal sinuses and anterior skull base.

Objective: To describe and analyze outcomes of the "multilayer centripetal technique" and "cranioendoscopic technique" in the treatment of malignancies of the sinonasal tract. Materials and methods: From June 1997 to June 2005, 67 patients with malignant tumors of the sinonasal tract were treated. A total of 49 patients underwent a sole endoscopic endonasal treatment and 18 a cranio-endoscopic treatment. The follow-up lasted from 6 to 108 months. American Joint Committee on Cancer-Union Internationale Contre le Cancer staging was: T1 = 17, T2 = 4, T3 = 9, T4a = 11, and T4b = 16. Esthesioneuroblastoma cases were staged according to Kadish: 3 = A, 4 = B, and 3 = C. All patients underwent surgical therapy but with different therapeutic intent: curative, salvage, or palliative. Results: Statistical analysis showed a 2-year survival rate higher than 80% in all histologic types of tumors, except for melanomas, according to other investigators in the literature. Conclusions: In this preliminary study, the endoscopic technique alone or in association with the cranial approach, in select cases, seems to be an effective method in the treatment of sinonasal tumors.