A new concept in therapy of esthesioneuroblastoma.

Background: We introduce a new concept in treatment of esthesioneuroblastom as, developed in the University Medical School of Graz, Austria. Patients a nd Methods: Six patients suffering from esthesioneuroblastoma have been tre ated in the years 1993-1999; five of them with a curative aspect, one with a palliative one. Three tumours were classified according to Kadish as stag e B, three as stage C. The selection criteria included tumours without deep infiltration into the orbit nor into the pterygopalatine fossa and without any involvement of the posterior wall of the frontal sinus. The treatment consists of endoscopic nasal and paranasal sinus surgery and consecutive st ereotactic radiosurgery by means of the Gamma-Knife unit. Results: Over an average follow-up period of 38 months all patients remained free of disease . Because of the minimally invasive character of our concept the complicati ons and side effects are minimised and the patients are less traumatised in comparison to conventional treatment such as craniofacial resection or irr adiation. Conclusion: Due to the excellent outcome of our six patients we r ecommend this new treatment concept, in selected cases, as an alternative t o the usual therapeutic modalities for esthesioneuroblastoma.