[Primary analysis of endoscopic surgery and endoscopic-assisted surgery for sinonasal malignancy].

OBJECTIVE: To investigate the feasibility and efficacy of endoscopic sinus surgery for sinonasal malignancy.

METHOD: Clinical data of 40 cases of sinonasal malignancy treated in our hospital from January 2007 to December 2011 were retrospectively analyzed. The pathological types encountered were: 5 cases of malignant transformation of sinonasal inverted papilloma, 2 cases of maxillary sinus carcinoma, 3 cases of ethmoid sinus carcinoma, 11 cases of mucosal melanoma, 7 cases of olfactory neuroblastoma, 2 cases of neuroendocrine carcinoma, 4 cases of myoepithelial carcinoma, 3 cases of adenoid cystic carcinoma, 1 case of malignant hemangiopericytoma. These patients were operated on either by an exclusive endoscopic surgery or endoscopic surgery with a complementary external approach. Thirty-two patients received adjuvant radiotherapy and/or chemotherapy.

RESULT: All the patients were followed up for a period of 1 to 5 years after operation, of which 18 cases survived for more than three years. Four cases recurred after six months to two years, but the result was satisfactory after revision endoscopic sinus surgery. Three cases occurred cervical lymph node metastasis, of which 2 cases received neck dissection and 1 case received chemotherapy and radiotherapy due to no surgical indications. Four cases occurred distant metastasis. Eight cases died of tumor until the last follow-up. The other 21 cases occurred no recurrence and metastasis during follow-up period.

CONCLUSION: Endoscopic sinus surgery is an effective method for sinonasal malignancy. Appropriate indication must be carefully selected for malignant tumor. Combined treatment based on surgery should be adopted to it.