Endoscopic-assisted craniofacial resection of esthesioneuroblastoma: minimizing facial incisions

Update Item Information
Publication Type Manuscript
School or College School of Medicine
Department Neurosurgery
Creator Couldwell, William T.; Orlandi, Richard R.; Jensen, Randy L.
Other Author Liu, James K.; O'Neill, Brent
Title Endoscopic-assisted craniofacial resection of esthesioneuroblastoma: minimizing facial incisions
Date 2003
Description The surgical management of esthesioneuroblastomas has traditionally been craniofacial resection, which combines a bifrontal craniotomy with a transfacial approach. The latter usually involves a disfiguring facial incision, mid-facial degloving, lateral rhinotomy, and/or extensive facial osteotomies, which may be cosmetically displeasing to the patient. The advent of angled endoscopes has provided excellent magnification and illumination for surgeons to remove tumors using minimally invasive techniques. The Author's describe their experience with three cases of esthesioneuroblastoma, which were surgically removed using a transnasal endoscopic approach, without the utilization of transfacial incisions. Preoperative radiographs were reviewed and tumors were staged according to the Kadish staging system. One patient had a recurrent esthesioneuroblastoma (Kadish stage B) which was removed entirely through a transnasal endoscopic approach. Two patients had intracranial extension (Kadish stage C), which were resected with a combined approach, endoscopically from below and a bifrontal craniotomy from above to remove intracranial disease. All patients underwent reconstruction of the anterior skull base. Esthesioneuroblastomas confined to the nasal and paranasal cavities (Kadish stage A and B), were readily accessible through the transnasal endoscopic approach. If there was significant intracranial disease (Kadish stage C), adding a bifrontal craniotomy provided excellent exposure for complete resection of involved tumor. All patients underwent complete tumor resection with negative margins. None had a cerebrospinal fluid (CSF) leak. The endoscopic-assisted craniofacial approach for the surgical management of esthesioneuroblastomas provides excellent exposure and adequate visualization as well as the cosmetic benefit of avoiding an external facial incision.
Type Text
Publisher Thieme Publishing Group
Volume 46
Issue 5
First Page 1
Last Page 15
Subject Esthesioneuroblastoma; Craniofacial resection; Endoscope; Craniofacial surgery; Minimally invasive
Subject LCSH Nasal cavity -- Cancer; Nasal cavity -- Surgery; Craniotomy
Language eng
Bibliographic Citation Liu, J. K., ONeill, B., Orlandi, R. R., Jensen, R. L., & Couldwell, W. T. (2003). Endoscopic-assisted craniofacial resection of esthesioneuroblastoma: minimizing facial incisions. Technical note and report of 3 cases. Minimally Invasive Neurosurgery, 46(5), 1-15.
Rights Management ©Thieme Publishing Group www.thieme-connect.com
Format Medium application/pdf
Format Extent 720,954 bytes
Identifier ir-main,12606
ARK ark:/87278/s6jw8z59
Setname ir_uspace
ID 704146
Reference URL https://collections.lib.utah.edu/ark:/87278/s6jw8z59
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