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Rodas A, Tariciotti L, Patel BK, Pradilla G, Solares CA. Endoscopic Surgery for Sinonasal and Skull Base Cancer. Surg Oncol Clin N Am 2024; 33:735-746. [PMID: 39244291 DOI: 10.1016/j.soc.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
The field of endoscopic endonasal surgery is in a constant state of advancement, with an expanding range of applications. Improvement in the diversity of instruments available, along with the increasing proficiency of surgical teams, has enabled the successful endoscopic treatment of complex sinonasal and skull base malignancies. Not only is the overall complication rate reduced by endoscopic approaches, but survival outcomes have also shown promising results when compared to traditional open approaches.
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Affiliation(s)
- Alejandra Rodas
- Department of Otolaryngology - Head and Neck Surgery, Emory University Hospital Midtown, 9th Floor, Medical Office Tower, 550 Peachtree NE, Atlanta, GA 30308, USA
| | - Leonardo Tariciotti
- Department of Neurosurgery, Emory Faculty Office Building, 49 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, USA
| | - Biren K Patel
- Department of Neurosurgery, Emory Faculty Office Building, 49 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, USA
| | - Gustavo Pradilla
- Department of Otolaryngology - Head and Neck Surgery, Emory University Hospital Midtown, 9th Floor, Medical Office Tower, 550 Peachtree NE, Atlanta, GA 30308, USA; Department of Neurosurgery, Emory Faculty Office Building, 49 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, USA
| | - C Arturo Solares
- Department of Otolaryngology - Head and Neck Surgery, Emory University Hospital Midtown, 9th Floor, Medical Office Tower, 550 Peachtree NE, Atlanta, GA 30308, USA; Department of Neurosurgery, Emory Faculty Office Building, 49 Jesse Hill Jr. Drive SE, Atlanta, GA 30303, USA.
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Leite AKN, de Alvarenga GF, Gonçalves S, dos Santos AB, Sterman H, Cernea CR, Kulcsar MAV, Kowalski LP, Matos LL. Short-term survival in extensive craniofacial resections. Clinics (Sao Paulo) 2021; 76:e2836. [PMID: 34037072 PMCID: PMC8112106 DOI: 10.6061/clinics/2021/e2836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/05/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Craniofacial resection (CFR) procedures for craniofacial tumors with cranial extension are often extensive. Although CFRs may yield good oncological results, there are concerns about high perioperative morbidity and mortality. This study aimed to determine risk factors for perioperative mortality after open CFR in terms of deaths occurring during index hospitalizations. METHODS We conducted a retrospective analysis of CFRs conducted at a tertiary oncology hospital from May 2009 through December 2018. RESULTS Our analysis included data from the medical records of 102 patients, the majority of whom were male (n=74, 72.5%). The mean age was 61 years (±18.3 years). Skin malignancies (n=64, 63.4%) accounted for nearly two-thirds of the treated tumors, and most of these were squamous cell carcinoma. Postoperative medical complications occurred in 33 patients (33%), and surgical complications occurred in 48 (47%). Multivariate analysis revealed the only independent risk factors for perioperative deaths to be the presence of intracranial tumor extension on preoperative imaging (hazard ratio [HR]=4.56; 95% confidence interval [CI]: 1.74-11.97; p=0.002) and the unexpected emergence of postoperative neurological dysfunction (HR=10.9; 95% CI: 2.21-54.3; p=0.003). CONCLUSIONS In our study, factors related to tumor extension were associated with a higher risk of perioperative death.
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Affiliation(s)
- Ana Kober N. Leite
- Departamento de Cirurgia de Cabeca e Pescoco, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR
- *Corresponding author. E-mail:
| | - Gustavo Fernandes de Alvarenga
- Departamento de Cirurgia de Cabeca e Pescoco, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Sérgio Gonçalves
- Departamento de Cirurgia de Cabeca e Pescoco, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Alexandre Bezerra dos Santos
- Departamento de Cirurgia de Cabeca e Pescoco, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Hugo Sterman
- Departamento de Neurocirurgia, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Claudio R. Cernea
- Departamento de Cirurgia de Cabeca e Pescoco, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Marco Aurélio V. Kulcsar
- Departamento de Cirurgia de Cabeca e Pescoco, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Luiz Paulo Kowalski
- Departamento de Cirurgia de Cabeca e Pescoco, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR
| | - Leandro Luongo Matos
- Departamento de Cirurgia de Cabeca e Pescoco, Instituto do Cancer do Estado de Sao Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP, BR
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