MALIGNANT-TUMORS OF THE ETHMOID SINUSES - POSTOPERATIVE AND LONG-TERMRESULTS IN A SERIES OF 41 CASES

A series of 41 malignant tumors including 31 adenocarcinomas invading the ethmoid sinuses were treated by a combined transcranial-transfacia l approach. Management, by the same team, of these consecutive cases p ermitted to analyze the technical problems and the carcinologic result s. Chemotherapy was given to 21 patients pre-operative followed by sur gical resection by a combined transbasal and paralateronasal routes an d then, by a post-operative radiotherapy. Post-operative complications were more frequent (52 %) in case of reconstruction of the anterior s kull base and especially with madroporic corals. In the other cases wh ere the double dural closure was only packed with abdominal subcutaneo us fat, the rate of post-operative problems was only 20 %. Noticeably, infection at the cranial base was observed in 6 cases (4 cases needin g a reoperation) with bone reconstruction and in none without reconstr uction. Actuarial survival rate was 84 % at 1 year, 53 % at 3 years an d 36 % at 5 years whatever the pathology (whole series or subgroup of adenocarcinomas). Mortality is related to incidental problems (3 cases ), another malignant primary disease (3 cases), metastasis (8 cases) a nd local recurrence (4 cases). A longer survival was observed in the g roup of patients without skull base invasion (survival rate 100 %, 83 %, 50 % at 1, 3 and 5 years respectively).