COMBINED TRANSFACIAL AND NEUROSURGICAL APPROACH TO MALIGNANT-TUMORS OF THE ETHMOID SINUS

In order to understand the risks and benefits of a combined transfacia l and neurosurgical procedure for neoplasms of the ethmoid sinus, we r eviewed all patients who underwent this surgical approach in our depar tment between 1986 and 1994. The study included 41 patients. Pathologi cal diagnoses included adenocarcinoma (31 patients), squamous cell car cinoma (three patients), aesthesioneuroblastoma (three patients), othe r (four patients). The overall morbidity rate was 39 per cent, and the post-operative mortality rate was 2.5 per cent. Complications were st atistically more likely in patients with bone skull base reconstructio n. The main carcinologic failures were local recurrences (24 per cent) and metastases (22 per cent). The one-year, three-year and five-year Kaplan Meir survival rates were respectively 84 per cent, 53 per cent and 36 per cent. In conclusion, the mortality and morbidity were accep table, especially when no bone skull base reconstruction was performed . Better local control justifies a combined procedure with post-operat ive radiotherapy when tumours involve or reach the skull base.