Author/Editor		Podboj, Jernej; Šmid, Lojze
Title		Endoskopska kirurgija malignih tumorjev nosu in obnosnih votlin - naše izkušnje
Translated title		Endoscopic surgery of malignant tumors of the nose and paranasal sinuses - our experience
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 39, št. Suppl 3
Publication year		2000
Volume		str. 39-43
Language		slo
Abstract		Introduction: Endoscopy and endoscopic surgery combined with classical procedures are well-established methods in the treatment of patients with malignomas of the nasal and paranasal cavities. Radical endoscopic excision of these tumors presents logical continuity in the development of endoscopic surgery. Material and methods: At the Department of otorhinolaryngology and cervicofacial surgery, University medical centre Ljubljana, since 1991 seven patients with nasal and paranasal sinus malignancies were operated with curative intent by endoscopic approach only. Among them, there were six cases of carcinoms and one olfactory neuroblastoma. Tumor was localised in ethmoids in five, on the posterior part of the nasal septum in one and on the inferior turbinate in one patient. Intraoperatively, the radicality of operation was histopathologicaly verified. Results: Operation was oncologicaly radical in six out of seven patients. There were no mayor intra or postoperative complications. Three patients were postoperatively irradiated. One of the patients is disease free 8 years, one 2 years, two 1 year and three 6 months after treatment. Conclusion: Indications for primary endoscopic surgical approach in the treatment of malignomas of the nose and paranasal sinues mostly depends on the extent and localisation of the tumor. Such operations should be performed only by highly experienced surgeon who is well aware about all the possibilities and limitations of endoscopic oncologic surgery.
Summary		Uvod: Endoskopija in endoskopska kirurgija v kombinaciji s klasičnimi posegi sta že povsem uveljavljeni metodi pri obravnavanju bolnikov z malignimi tumorji nosu in obnosnih votlin. Endoskopsko radikalno odstranjevanje teh tumorjev je logično nadaljevanje v razvoju endoskopske kirurgije. Bolniki: Od leta 1991 smo na Kliniki za otorinolaringologijo in cervikofacialno kirurgijo v Ljubljani endoskopsko operirali sedem bolnikov s tumorji nosu in obnosnih votlin. Histološko je bilo šest karcinomov in en olfaktorni nevroblastom. Pet tumorjev je bilo v sitki, eden na spodnji nosni školjki, eden pa na nosnem pretinu. En tumor smo opredelili kot rT1NOM0, tri kot T2NOM0, enega kot T4NOM0 (olfaktorni nevroblastom in primarni tumor nosne votline nista razporejena). Po resekciji tumorja smo jemali vzorce tkiva z robov defektov in jih histološko pregledovali z zaledenelimi rezi. Med posegi ni bilo večjih zapletov. Trije bolniki so bili pooperacijsko obsevani. Rezultati: Razen enega so bili tumorji primarno radikalno odstranjeni. Ena bolnica je brez ponovitve 8 let po operaciji, en bolnik 2 leti, dva bolnika eno leto in trije bolniki pol leta po končanem zdravljenju. Zaključki: Indikacije za endoskopske radikalne operacije malignih tumorjev nosu in obnosnih votlin so ožje in težje določljive kot pri že uveljavljenih pristopih. Osnovni pogoj za uspeh kurativne endoskoskopske operacije je strogo upoštevanje temeljnega onkološkega načela o radikalnosti. Endoskopske operacije imajo pred klasičnimi posegi veliko prednosti, vendar tudi določene slabosti in nikakor ne smejo biti narejene na račun radikalnosti. Kirurg, ki se odloča za tak poseg, mora dobro poznati možnosti in meje endoskopske kirurgije in se v primerih, ko zgolj endoskopsko ne more radikalno odstraniti tumorja, odločiti za klasični pristop.
Descriptors		NOSE NEOPLASMS SURGERY, ENDOSCOPIC PARANASAL SINUS NEOPLASMS NEOPLASM STAGING RECURRENCE TREATMENT OUTCOME