Maggiore Giandomenico, Lazio Maria Silvia, Gallo Oreste
Clinic of Otolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, University of Florence, Italy.
Clinic of Otolaryngology, Head and Neck Surgery, Department of Translational Surgery and Medicine, University of Florence, Italy.
Auris Nasus Larynx. 2018 Oct;45(5):1107-1112. doi: 10.1016/j.anl.2018.02.003. Epub 2018 Feb 21.
Olfactory neuroblastoma is a rare malignant tumor of neuroectodermal origin and represents the most common cancer of the nasal cavity in pediatric age. The gold standard of treatment consists of en bloc resection, numerous studies have shown as the endoscopic approaches permit good control of the disease improving the quality of life after the treatment. Herein we describe the case of a 13-year-old patient referred to our outpatient clinic with a polypoid multi-lobed lesion occupying the left nasal cavity and imaging that confirmed a left-sided nasal mass without cribriform plate involvement (Kadish B). We performed an unilateral endoscopic resection with transnasal craniectomy and anterior skull base reconstruction with a flap from the contralateral nasal septum based on the septal branches of the anterior and posterior ethmoidal arteries (Septal Flip Flap, SFF), that provided a faster healing process with reduction of nasal crusting, improvement in the quality of life of patient in the postoperative period and the preservation of the contralateral olfactory bulb that has allowed to save the smell. This treatment strategy of pediatric esthesioneuroblastoma was analyzed in the context of the current literature.
嗅神经母细胞瘤是一种罕见的神经外胚层起源的恶性肿瘤，是儿童期鼻腔最常见的癌症。治疗的金标准是整块切除，大量研究表明，内镜手术能够很好地控制疾病，提高治疗后的生活质量。在此，我们描述了一名13岁患者的病例，该患者因左侧鼻腔内有一个息肉样多叶病变前来我们的门诊就诊，影像学检查证实为左侧鼻腔肿物，未累及筛板（卡迪什B期）。我们采用经鼻颅骨切除术进行单侧内镜切除，并基于前后筛动脉的鼻中隔分支，用对侧鼻中隔瓣进行前颅底重建（鼻中隔翻转瓣，SFF），这使得愈合过程更快，减少了鼻痂形成，改善了患者术后的生活质量，并保留了对侧嗅球，从而保留了嗅觉。我们结合当前文献分析了小儿嗅神经母细胞瘤的这种治疗策略。
