Avtor/Urednik		Podboj, Jernej; Šmid, Lojze; Boršoš, Imre; Spudič, Štefan
Naslov		Vloga endoskopske kirurgije pri zdravljenju malignih tumorjev nosu in obnosnih votlin
Prevedeni naslov		The role of endoscopic surgry in the treatment of nasal and paranasal sinus malignant tumors
Tip		članek
Vir		Med Razgl
Vol. in št.		Letnik 43, št. Suppl 3
Leto izdaje		2004
Obseg		str. 207-10
Jezik		slo
Abstrakt		During the period between 1991 and 2004, fifteen patients with nasal and paranasal sinus malignancies underwent endoscopic surgery with curative intent at the Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre, Ljubljana. Among them were five adenocarcinomas, five sinonasal carcinomas, two malignant melanomas, one olfactory neuroblastoma, one chondrosarcoma and one leiomyosarcoma. In nine patients, the tumor originated from the ethmoids and in six from the nasal cavities. Following tumor resection, oncologic radicality was verified intraoperatively with multiple biopsies from the margins of the defect. The operation was oncologically radical in fourteen out of fifteen operated patients. There were no major intraoperative complications. Follow-up of the treated patients ranged from 8 to 149 months (mean 39 months). In the patient with malignant melanoma, the disease recurred 30 months after surgery, while all other patients are disease free. On the basis of our own experience, it is believed that in selected cases endoscopic surgery with curative intent for removal of malignant tumors in the nasal and paranasal cavities in the hands of a highly experienced surgeon has advantage over other conventional procedures.
Izvleček		Od leta 1991 do 2004 smo na Kliniki za otorinolaringologijo in cervikofacialno kirurgijo v Ljubljani endoskopsko operirali petnajst bolnikov z malignimi tumorji nosu in obnosnih votlin. Po histološki sliki je bilo po pet adenokarcinomov in sinonazalnih cilindroceličnih karcinomov, dva maligna melanoma in po en olfaktorni nevroblastom, hondrosarkom in leiomiosarkom. Pri devetih bolnikih je tumor izhajal iz etmoidov, pri šestih iz nosne votline. Po resekciji tumorja smo jemali vzorce tkiva z robov defektov in jih histološko pregledovali z zaledenelimi rezi. Med posegi ni bilo večjih zapletov. Razen enega so bili tumorji primarno radikalno odstranjeni. Čas spremljanja bolnikov je od 8 do 149 mesecev (mediana znaša 39 mesecev). Bolnik z malignim melanomom je imel 30 mesecev po končanem zdravljenju lokalno ponovitev, pri 14 bolnikih ni ponovitve bolezni. Endoskopske operacije imajo pred klasičnimi posegi veliko prednosti, vendar tudi določene slabosti in nikakor ne smejo biti narejene na račun radikalnosti. Na osnovi dosedanjih izkušenj menimo, da je pri izbranih bolnikih endoskopska resekcija z namenom radikalne odstranitve malignega tumorja bolj smiselna kot odstranitev s klasičnim pristopom.
Deskriptorji		NOSE NEOPLASMS PARANASAL SINUS NEOPLASMS SURGERY, ENDOSCOPIC TREATMENT OUTCOME