Endonasal endoscopic resection of esthesioneuroblastoma: The Johns Hopkins Hospital experience and review of the literature

Gary L. Gallia, Douglas D. Reh, Vafi Salmasi, Ari M. Blitz, Wayne Koch, Masaru Ishii

Research output: Contribution to journalArticle

Abstract

Esthesioneuroblastoma is an uncommon malignant tumor originating in the upper nasal cavity. The surgical treatment for this tumor has traditionally been via an open craniofacial resection. Over the past decade, there has been tremendous development in endoscopic techniques. In this report, we performed a retrospective analysis of patients with esthesioneuroblastomas treated with a purely endonasal endoscopic approach and resection at the Johns Hopkins Hospital between January 2005 and April 2010. A total of eight patients with esthesioneuroblastoma, five men and three women, were identified. Six patients were treated for primary disease, and two were treated for tumor recurrence. The modified Kadish staging was A in one patient (12.5%), B in two patients (25%), C in four patients (50%), and D in one patient (12.5%). All patients had a complete resection with negative intraoperative margins. One patient had intraoperative hypertension; there were no perioperative complications. With a mean follow-up of over 27 months, all patients are without evidence of disease. In addition, we reviewed the literature and identified several overlapping case series of patients with esthesioneuroblastoma treated via a purely endoscopic technique. Our series adds to the growing experience of expanded endonasal endoscopic surgery in the treatment of skull base tumors including esthesioneuroblastoma. Longer follow-up on a larger number of patients is required to further demonstrate the utility of endoscopic approaches in the management of this malignancy.

Original languageEnglish (US)
Pages (from-to)465-475
Number of pages11
JournalNeurosurgical Review
Volume34
Issue number4
DOIs
StatePublished - Oct 2011

Keywords

  • Endoscopic
  • Endoscopy
  • Esthesioneuroblastoma
  • Expanded endonasal approach
  • Olfactory neuroblastoma
  • Skull base

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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