Irish J, Dasgupta R, Freeman J, Gullane P, Gentili F, Brown D, Neligan P, O'Sullivan B
Department of Otolaryngology/Head and Neck Program, Princess Margaret Hospital; University of Toronto Faculty of Medicine, Ontario.
J Otolaryngol. 1997 Feb;26(1):1-7.
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.
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.
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.
Failure analysis suggests that radical surgical resection combined with radiotherapy provides the best chance of disease control.
本研究旨在评估根治性手术切除联合放疗治疗嗅神经母细胞瘤的有效性，嗅神经母细胞瘤是一种罕见的恶性肿瘤，占鼻腔恶性肿瘤的1%至5%。
对在我们机构接受治疗的12例患者进行的10年回顾表明，由耳鼻喉科/神经外科联合颅面入路组成的初始治疗可实现良好的局部控制，且发病率和并发症相对较低。由于症状和体征不具特异性，患者往往就诊时已处于疾病晚期。83%的患者接受了手术和放疗联合治疗。
75%的患者疾病无进展，平均随访时间为54个月。基于我们在前颅底手术（I区）的经验，我们强烈主张使用帽状腱膜瓣进行硬脑膜重建。25%的病例出现术后并发症，无术后死亡病例。
失败分析表明，根治性手术切除联合放疗提供了控制疾病的最佳机会。
