Podboj J, Smid L
Clinical Center, University Department of Otorhinolaryngology and Cervicofacial Surgery, Zaloska 2, 1525 Ljubljana, Slovenia.
Eur J Surg Oncol. 2007 Nov;33(9):1081-6. doi: 10.1016/j.ejso.2007.01.016. Epub 2007 Feb 27.
To assess the efficacy of endoscopic surgical treatment in patients with nasal and paranasal sinus malignancies.
During the period 1991-2006, 16 patients with nasal and paranasal sinus malignancies underwent endoscopic surgery with curative intent. The lesions included 11 carcinomas, two malignant melanomas, one olfactory neuroblastoma, one hondrosarcoma and one leiomyosarcoma. Tumors originated from the ethmoids in eight, and from the nasal cavity in another eight patients. Oncologic radicality of resection was verified by intraoperative frozen-section examination of biopsy specimens from the margins of the defect site.
Radical resection was accomplished in 15 out of 16 operated patients. There were no major intra- or postoperative complications. Ten patients were postoperatively irradiated. Follow up of the treated patients ranged from 15 to 178 months (median 67 months). One patient with malignant melanoma died of generalized disease nine months after treatment, another with malignant melanoma recurred locally 30 months and again 49 months after first operation and is at the time of evaluation disease free and one died 21 months after operation without evidence of disease.
It seems that in selected cases, endoscopic surgery with curative intent for removal of malignant tumors of the nasal and paranasal cavities in the hands of highly experienced surgeon is justified.
评估鼻及鼻窦恶性肿瘤患者内镜手术治疗的疗效。
1991年至2006年期间，16例鼻及鼻窦恶性肿瘤患者接受了根治性内镜手术。病变包括11例癌、2例恶性黑色素瘤、1例嗅神经母细胞瘤、1例软骨肉瘤和1例平滑肌肉瘤。8例肿瘤起源于筛窦，另8例起源于鼻腔。通过对缺损部位边缘活检标本进行术中冰冻切片检查来验证切除的肿瘤根治性。
16例手术患者中有15例实现了根治性切除。无严重术中或术后并发症。10例患者术后接受了放疗。治疗患者的随访时间为15至178个月（中位时间67个月）。1例恶性黑色素瘤患者在治疗9个月后死于全身疾病，另1例恶性黑色素瘤患者在首次手术后30个月局部复发，49个月后再次复发，在评估时无疾病，1例患者术后21个月死亡，无疾病证据。
在经验丰富的外科医生手中，对于某些选定病例，采用根治性内镜手术切除鼻腔和鼻窦恶性肿瘤似乎是合理的。
