Riassunto analitico
BACKGROUND: advanced sinonasal tumours often present with orbital involvement. Surgical treatment and radical excision are also possible, preserving the eye. Oncological safety and functional outcome of the preserved eye are the counterpart in orbital preservation surgery. Irrespective of the orbital invasion, tumour histology influences the prognosis. Surgical approaches to the orbit in sinonasal tumour are divided in anterior and posterolateral procedures. The combined transfacial and trancranial surgical approaches have been well described in the literature for craniofacial resection, when the anterior or medium skull base are involved. Multidisciplinary collaboration with microscopic and/or endoscopic control have improved surgical technique to extirpate tumours extended to dura, spehenopalatine area and pterygomaxilmary fissure, infratemporal fossa, roof of nasopharynx and apex of orbit. We describe the multiphase combined surgical approach with maxillofacial, otolaryngology and neurosurgical collaboration in sinonasal tumour treatment.
AIM: the aim of this study is evaluating patients’ survival in paranasal and craniofacial tumors with orbital involvement, treated in Head & Neck Department of University Hospital of Modena.Post treatment QOL as been also evaluated.
METHODS: from 2001 to 2015 we evaluated the clinical history of 83 patients (44 M / 39 F), who were surgically treated in Head & Neck Department. We have analyzed the following oncological variables: tumors histology, orbital and intracranial involvement, tumors recurrence and staging. Quality of life assessment was estimated through UW- QOL and modified version of GO- QOL.
RESULTS: the overall survival is 55.3 % at five years. These data are consistent to English scientific literature; Melanoma group as the lowest survival. Intracranial and orbital involvement are related to a lower survivals. Survival analysis doesn’t show significant results, considering surgical margins infiltration. The risk of recurrence is higher in T4 stage, as other Authors have reported.
The study of quality of life involved 35 patients (29 with benign tumors, 24 with malignant tumors): the mood affects considerably QOL score (best score 50.9%), followed by anxiety (best score 56.6%).
CONCLUSIONS: the results are comparable to other studies but have the limit of low numbers. The quality of life assessment point out that less invasive surgical approaches are related to a better patient’s image reservation and to a better social life.
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Abstract
BACKGROUND: advanced sinonasal tumours often present with orbital involvement. Surgical treatment and radical excision are also possible, preserving the eye. Oncological safety and functional outcome of the preserved eye are the counterpart in orbital preservation surgery. Irrespective of the orbital invasion, tumour histology influences the prognosis. Surgical approaches to the orbit in sinonasal tumour are divided in anterior and posterolateral procedures. The combined transfacial and trancranial surgical approaches have been well described in the literature for craniofacial resection, when the anterior or medium skull base are involved. Multidisciplinary collaboration with microscopic and/or endoscopic control have improved surgical technique to extirpate tumours extended to dura, spehenopalatine area and pterygomaxilmary fissure, infratemporal fossa, roof of nasopharynx and apex of orbit. We describe the multiphase combined surgical approach with maxillofacial, otolaryngology and neurosurgical collaboration in sinonasal tumour treatment.
AIM: the aim of this study is evaluating patients’ survival in paranasal and craniofacial tumors with orbital involvement, treated in Head & Neck Department of University Hospital of Modena. Post treatment QOL as been also evaluated.
METHODS: from 2001 to 2015 we evaluated the clinical history of 83 patients (44 M / 39 F), who were surgically treated in Head & Neck Department. We have analyzed the following oncological variables: tumors histology, orbital and intracranial involvement, tumors recurrence and staging. Quality of life assessment was estimated through UW- QOL and modified version of GO- QOL.
RESULTS: the overall survival is 55.3 % at five years. These data are consistent to English scientific literature; Melanoma group as the lowest survival. Intracranial and orbital involvement are related to a lower survivals. Survival analysis doesn’t show significant results, considering surgical margins infiltration. The risk of recurrence is higher in T4 stage, as other Authors have reported.
The study of quality of life involved 35 patients (29 with benign tumors, 24 with malignant tumors): the mood affects considerably QOL score (best score 50.9%), followed by anxiety (best score 56.6%).
CONCLUSIONS: the results are comparable to other studies but have the limit of low numbers. The quality of life assessment point out that less invasive surgical approaches are related to a better patient’s image reservation and to a better social life.
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