Subscribe to RSS
DOI: 10.1055/s-0041-1729978
Comparative Outcomes by Surgical Approach in Patients with Malignant Sinonasal Disease
![](https://www.thieme-connect.de/media/jnlsb/2022S02/lookinside/thumbnails/10-1055-s-0041-1729978_200401-1.jpg)
Abstract
Objective There is a paucity of data on comparative outcomes for open versus endoscopic surgery for patients with malignant sinonasal pathology. Most of the available studies are limited by a sample size <100 patients.
Design This is a retrospective cohort study.
Setting The findings of this study come from a single-institution tertiary care center from 2008 to 2019.
Participants In total, 199 patients who underwent surgery for malignant sinonasal disease participated in this study.
Main Outcome Measures The main outcome measures were perioperative complications and reoperation.
Results Patients in our sample had a mean age of 59.7 years (SD, 20.4). In total, 62% were male and 72% were white. An endoscopic-only approach was used in 41% of patients and an open or combined approach in 59% of patients. Squamous cell carcinoma was the most common pathology (43.0%), followed by sarcoma (9.5%), skin cancer (6.5%), sinonasal undifferentiated carcinoma (6.5%), and adenocarcinoma (5.5%). The all-cause complication rate was 14.6%. Patients with an open resection had a higher rate of intraoperative complications (5.9 vs. 0%; p = 0.043), postoperative complications (19.5 vs. 3.7%; p = 0.001), and all-cause complications (21.0 vs. 3.7%; p < 0.001). The likelihood of early reoperation (<6 months) or late reoperation (>6 months) did not significantly differ by surgical approach (p = 1.000 and 0.741, respectively).
Conclusion The endoscopic approach for resection of malignant sinonasal disease is viable for select patients and may be associated with a favorable complication rate compared with the open approach.
Keywords
skull base neoplasms - intraoperative complications - postoperative complications - treatment outcomePublication History
Received: 06 December 2020
Accepted: 27 February 2021
Article published online:
29 May 2021
© 2021. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Dutta R, Dubal PM, Svider PF, Liu JK, Baredes S, Eloy JA. Sinonasal malignancies: a population-based analysis of site-specific incidence and survival. Laryngoscope 2015; 125 (11) 2491-2497
- 2 Snyderman CH, Pant H, Carrau RL, Prevedello D, Gardner P, Kassam AB. What are the limits of endoscopic sinus surgery?: the expanded endonasal approach to the skull base. Keio J Med 2009; 58 (03) 152-160
- 3 Rawal RB, Farzal Z, Federspiel JJ, Sreenath SB, Thorp BD, Zanation AM. Endoscopic resection of sinonasal malignancy: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 2016; 155 (03) 376-386
- 4 Farquhar D, Kim L, Worrall D. et al. Propensity score analysis of endoscopic and open approaches to malignant paranasal and anterior skull base tumor outcomes. Laryngoscope 2016; 126 (08) 1724-1729
- 5 Povolotskiy R, Farber NI, Bavier RD, Cerasiello SY, Eloy JA, Hsueh WD. Endoscopic versus open resection of non-squamous cell carcinoma sinonasal malignancies. Laryngoscope 2020; 130 (08) 1872-1876
- 6 Lu VM, Ravindran K, Phan K. et al. Surgical outcomes of endoscopic versus open resection for primary sinonasal malignancy: a meta-analysis. Am J Rhinol Allergy 2019; 33 (05) 608-616
- 7 Hagemann J, Roesner J, Helling S. et al. Long-term outcome for open and endoscopically resected sinonasal tumors. Otolaryngol Head Neck Surg 2019; 160 (05) 862-869
- 8 Saedi B, Aghili M, Motiee M, Valadkhani S, Niazi AB, Safavi A. Surgical outcomes of malignant sinonasal tumours: open versus endoscopic surgical approaches. J Laryngol Otol 2014; 128 (09) 784-790
- 9 Arnold A, Ziglinas P, Ochs K. et al. Therapy options and long-term results of sinonasal malignancies. Oral Oncol 2012; 48 (10) 1031-1037
- 10 Fu TS, Monteiro E, Witterick I. et al. Costs and perioperative outcomes associated with open versus endoscopic resection of sinonasal malignancies with skull base involvement. J Neurol Surg B Skull Base 2017; 78 (05) 430-440
- 11 Naunheim MR, Goyal N, Dedmon MM. et al. An algorithm for surgical approach to the anterior skull base. J Neurol Surg B Skull Base 2016; 77 (04) 364-370
- 12 Turner JH, Reh DD. Incidence and survival in patients with sinonasal cancer: a historical analysis of population-based data. Head Neck 2012; 34 (06) 877-885
- 13 Husain Q, Joshi RR, Cracchiolo JR. et al. Surgical management patterns of sinonasal malignancy: a population-based study. J Neurol Surg B Skull Base 2019; 80 (04) 371-379
- 14 Casler JD, Doolittle AM, Mair EA. Endoscopic surgery of the anterior skull base. Laryngoscope 2005; 115 (01) 16-24
- 15 Abdelmeguid AS, Raza SM, Su SY. et al. Endoscopic resection of sinonasal malignancies. Head Neck 2020; 42 (04) 645-652
- 16 Farber NI, Bavier RD, Crippen MM, Vatsa N, Hsueh WD, Eloy JA. Comparing endoscopic resection and open resection for management of sinonasal mucosal melanoma. Int Forum Allergy Rhinol 2019; 9 (12) 1492-1498
- 17 Eloy JA, Vivero RJ, Hoang K. et al. Comparison of transnasal endoscopic and open craniofacial resection for malignant tumors of the anterior skull base. Laryngoscope 2009; 119 (05) 834-840