Olfaction Preservation and Long-Term Outcomes in Patients with Unilateral Endoscopic Resection of Olfactory Neuroblastoma: A Systematic Review and Institutional Experience.

Autor: Rodas A; Department of Otolaryngology and Head & Neck Surgery, Emory University, Atlanta, Georgia, USA., Tariciotti L; Department of Neurosurgery, Emory University, Atlanta, Georgia, USA; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy., Zohdy YM; Department of Neurosurgery, Emory University, Atlanta, Georgia, USA., Soriano RM; Department of Otolaryngology and Head & Neck Surgery, Emory University, Atlanta, Georgia, USA., Daoud GE; Department of Otolaryngology and Head & Neck Surgery, Emory University, Atlanta, Georgia, USA., Porto E; Department of Neurosurgery, Emory University, Atlanta, Georgia, USA; Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy., Vuncannon JR; Department of Otolaryngology and Head & Neck Surgery, Emory University, Atlanta, Georgia, USA., Revuelta-Barbero JM; Department of Neurosurgery, Emory University, Atlanta, Georgia, USA., Garzon-Muvdi T; Department of Otolaryngology and Head & Neck Surgery, Emory University, Atlanta, Georgia, USA; Department of Neurosurgery, Emory University, Atlanta, Georgia, USA., McDonald M; Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA., Pradilla G; Department of Otolaryngology and Head & Neck Surgery, Emory University, Atlanta, Georgia, USA; Department of Neurosurgery, Emory University, Atlanta, Georgia, USA., Wise SK; Department of Otolaryngology and Head & Neck Surgery, Emory University, Atlanta, Georgia, USA., Barrow E; Department of Otolaryngology and Head & Neck Surgery, Emory University, Atlanta, Georgia, USA., Solares CA; Department of Otolaryngology and Head & Neck Surgery, Emory University, Atlanta, Georgia, USA; Department of Neurosurgery, Emory University, Atlanta, Georgia, USA., DelGaudio JM; Department of Otolaryngology and Head & Neck Surgery, Emory University, Atlanta, Georgia, USA. Electronic address: jdelgau@emory.edu.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Oct; Vol. 190, pp. e874-e882. Date of Electronic Publication: 2024 Aug 09.
DOI: 10.1016/j.wneu.2024.08.028
Abstrakt: Background: Endoscopic endonasal surgical resection is an effective therapeutic approach for olfactory neuroblastoma (ONB). Unilateral excision of ONBs with limited extension has been reported with the purpose of preserving olfactory function. We aimed to review implications of surgical management, olfactory preservation feasibility, and survival outcomes in patients who underwent endoscopic unilateral resection of ONB.
Methods: A systematic literature review was conducted using the search terms [("Olfactory neuroblastoma") OR ("Esthesioneuroblastoma")] AND [("Unilateral resection") OR ("Olfaction preservation")]. Studies reporting cases of unilateral ONB endoscopic resection with postoperative olfaction assessment were included. Concurrently, records of patients who met inclusion criteria at our institution were reviewed retrospectively. The survival and olfactory outcomes were analyzed in both cohorts.
Results: Thirty-three patients were identified in the published literature. Twenty-three (69.7%) reported postoperative olfaction preservation. Olfactory function after surgery did not show an association with Kadish stage (P = 0.128). No evidence of disease was observed at the latest follow-up in this group of patients. Nine patients who met inclusion criteria were identified at our institution. The extent of resection influenced the level of olfaction preservation when cribriform plate and nasal septum resection coexisted (P = 0.05). A single patient at our institution developed recurrence after being lost to follow-up for 22 months.
Conclusions: Olfaction preservation can be achieved in patients who undergo endoscopic unilateral resection and adjuvant radiotherapy. The extent of resection should aim for negative margins, particularly in the midline. Larger studies are required to assess the risk of contralateral microscopic disease, and, hence, close follow-up is advised.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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