Role of endoscopic surgery in the management of selected malignant epithelial neoplasms of the naso-ethmoidal complex

BACKGROUND: This study reviews the outcome of patients with adenocarcinoma (AC) and squamous cell carcinoma (SCC) of the naso-ethmoidal complex treated by endoscopic surgery. METHODS: Sixteen patients underwent a purely endoscopic excision of AC (n = 12) or SCC (n = 4) at 2 university hospitals. All patients were prospectively followed by endoscopic and MRI evaluations. RESULTS: The tumor originated from the ethmoid in 13 cases and the nasal fossa in 3. Lesions were staged as follows: 5 T1, 10 T2, and 1 T3. Adjuvant radiotherapy was delivered in 7 cases. Follow-up (range, 28-70 months; mean, 47.25) was available for all patients. One patient died for brain metastases 28 months after surgery. Another patient required salvage craniofacial resection and radiotherapy for recurrent AC. Five-year disease-specific and disease-free survival rates were 93.3% and 87.0%, respectively. CONCLUSIONS: In selected T1-T2 lesions of the naso-ethmoidal complex, endoscopic surgery seems to offer a satisfactory alternative to external procedures.