| Abstrakt: |
Objective: To illustrate an transnasal approach (endoscopic assisted transnasal‐craniectomy) used for olfactory neuroblatoma treatment and to advocate this method of management followed by radiation therapy for selected cases, based on the Stamm‐Kennedy (SK) stage system. Method: A retrospective chart review was performed with 16 patients harboring olfactory neuroblastomas. Patients were categorized secondary to SK staging system. Twelve patients underwent the endoscopic assisted transnasal craniectomy (EATNC) approach, and 4 were submitted to hybrid approach (cranio‐endoscopic) between 2000 and 2011 at a tertiary referral center. Results: Seven SK‐IVa, 5 SK‐II, 2 SK‐IVb, 1 SK‐I, and 1 SK‐V patients, aged 10 to 67 years (9 females and 7 males), were identified. In 10 cases the tumor was bilateral, and in six cases the tumor was unilateral. Twelve patients were submitted to EATNC, 4 patients were submitted to hybrid approach (cranio‐endoscopic), and 1 was submitted to endonasal approach without craniectomy. Gross total resection was achieved in 12, and near total was achieved in 4 patients. Twelve patients were submitted to radiotherapy (75%). Four cases needed posterior surgery. Fourteen patients were disease free 5 to 72 months postresection, and 2 patients were lost during follow‐up. Only 4 patients preserved olfactory function (unilateral cases treated without radiotherapy). Conclusion: The EATNC is a promising approach for olfactory neuroblastoma treatment, even for those tumors with intradural extension. Most patients require radiation therapy, and in these cases there is no olfaction preservation. [ABSTRACT FROM AUTHOR] |
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