EFFECTIVENESS OF ENDONASAL ENDOSCOPIC EXCISION IN BENIGN SINONASAL TUMORS
1Ankara Üniversitesi, Kulak Burun Boğaz Hastalıkları, Ankara, Türkiye Introduction Currently with the developing technology, endoscopes have been used widely for treatment of sinonasal diseases. Thanks to experience gained from this endoscopic sinus surgeries; surgeons started to use this minimally invasive approach for sinonasal tumors. The aim of this study is to assess the efficacy and reliability of endonasal endoscopic resection in benign sinonasal tumors in cases where navigation is not used.Material Method: All patients operated for benign sinonasal tumors with endonasal endoscopic approach without navigation use during seven years period in Ankara University Department of ENT were included in this study. Demographics, symptoms, signs, duration of complaints, radiological and surgical findings, histopathological results were examined.
Results: 165 patients were included in the study. In the juvenile nasopharyngeal angioibrom group, 12 patients (92.4%) were primary cases and 1 patient (7.6%) was secondary, No postoperative recurrence was observed.When looking at the inverted papilloma group, 10 patients (19.6%) were secondary, while 41 (80.3%) were primary cases. Recurrrens were observed in two (3.9%) patients. Pathology results showed dysplasia in 2 (3.9%), high mytotic activity in 1(1.9%) and malign transformation in 2 (3.9%). Among the fibroosseous lesion group, 55 (94.8%) were primary and 3 ( 5.2%) were secondary cases. During the operation 3 (5.1%) patients had cerebral spinal fluid (BOS) leak and postoperatively revision frontal sinus surgery was performed in 6 (33.3%). In the other benign sinonasal tumor group, 15 meningoencephalocele, 13 hemangiomas, 5 Schwannomas, 5 Meningiomas, 2 Inflammatory myofibroblastic tumor and 1 leiomyoma, chondroma and germ cell tumor resection were evaluated.
Conclusion Endonasal endoscopic approach should be applied by experienced surgeons who are familiar with the anatomy of the region due to possible intraoperative risks in benign sinonasal tumor surgery. Patient selection for endoscopic approach and need for navigation use should be assessed case by case according to surgeons experience, histopathologic diagnosis, location and extension of the tumor.
Keywords : Sinonasal tumor, Benign tumor, Endonasal endoscopic aproach, Inverted papilloma, Fibroosseous lesion