xRead - Nasal Obstruction (September 2024) Full Articles

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ICAR SINONASAL TUMORS

tumor, sinonasal undifferentiated carcinoma, skull base, squamous cell carcinoma, surgery, surveillance, survival, survivorship

Table of contents I. EXECUTIVE SUMMARY . . . . . . . . . . . . A. Introduction................. B. Methods................... C. Results.................... Section 1: General principles . . . . . . . . . Section 2: Benign lesions and neoplasms. . . Section 3: Malignant neoplasms . . . . . . . Section 4: Morbidity, QOL, and surveillance . D. Discussion.................. II. INTRODUCTION................ III. METHODS................... A. Topic development. . . . . . . . . . . . . . B. Iterativereview................ C. ICSNT statement development . . . . . . . D. Limitations ................. SECTION I: GENERAL PRINCIPLES . . . . . . . . IV. INCIDENCE AND EPIDEMIOLOGY. . . . . . V. GENERAL RISK FACTORS . . . . . . . . . . . A. Age ..................... B. Geneticsex.................. C. Ethnicity................... D. Occupational exposure. . . . . . . . . . . . E. Smoking................... F. Link to viral infections . . . . . . . . . . . . G. Genetic and other inherited traits . . . . . . VI. PRINCIPLES OF SURGICAL TREATMENT . . 53 A. En Bloc versus debulking/piecemeal resection 53 B. Treatment of sites of attachment . . . . . . . 55 C. Differences between benign and malignant pathologies.................. 57 D. Riskoftumorseeding . . . . . . . . . . . . 57 VII. BIOPSY .................... 58 A. Role of in-office biopsies for sinonasal lesions 59 B. Indications.................. 59 C. Technical considerations. . . . . . . . . . . 60 D. Order of imaging and biopsy. . . . . . . . . 61 VIII. RESECTABILITY. . . . . . . . . . . . . . . 61 A. Resectability of sinonasal tumors . . . . . . 61 B. Orbital apex involvement . . . . . . . . . . 62 C. Carotid artery involvement . . . . . . . . . 62 D. Skull base involvement . . . . . . . . . . . 63 E. Pterygopalatine and infratemporal fossa involvement................. 65 IX. WORKUP OF REGIONAL AND DISTANT DISEASE..................... 65 A. Retropharyngeal lymphadenopathy . . . . . 68 10 10 10 11 11 17 20 35 38 39 40 40 41 41 43 43 43 45 45 45 45 46 49 49 49

B. Anatomicimaging. . . . . . . . . . . . . . C. Functional imaging . . . . . . . . . . . . . D. Biopsy.................... X. SURGICAL APPROACH . . . . . . . . . . . . A. Squamous cell carcinoma . . . . . . . . . . B. Olfactory neuroblastoma. . . . . . . . . . . C. Adenocarcinoma............... D. Sinonasalsarcoma. . . . . . . . . . . . . . E. Sinonasal mucosal melanoma . . . . . . . . F. Overalloutcomes. . . . . . . . . . . . . . . G. Approaches to the maxillary sinus. . . . . . XI. MANAGEMENT OF THE ORBIT . . . . . . . 89 A. Orbital structures and grading orbital invasion 89 B. Orbital preservation versus orbital exenteration................. 90 C. Management of the nasolacrimal system and role of dacryocystorhinostomy . . . . . . . . 94 D. Advancements in endoscopic orbital approaches and role for open orbital approaches.................. 94 XII. MARGINANALYSIS . . . . . . . . . . . . . 95 A. Techniques.................. 96 B. Frozen sections for margin analysis . . . . . 105 C. Margin status and survival . . . . . . . . . . 107 XIII. MANAGEMENT OF RECURRENT MALIGNANCY................. 108 A. Diagnosis of recurrent tumor . . . . . . . . 108 B. Role of salvage surgery . . . . . . . . . . . . 110 C. Role of re-irradiation. . . . . . . . . . . . . 112 D. Role of palliative therapies. . . . . . . . . . 112 E. Differences in outcomes between primary and salvage treatment . . . . . . . . . . . . 114 XIV. RADIATION MODALITIES FOR TREATMENT OF SINONASAL MALIGNANCIES................ 116 A. Intensity-modulated radiotherapy . . . . . . 116 B. Proton beam therapy. . . . . . . . . . . . . 122 C. Fast neutron radiotherapy . . . . . . . . . . 122 D. Carbon ion radiotherapy. . . . . . . . . . . 125 SECTION II: BENIGN LESIONS AND NEOPLASMS 131 XV. BENIGN MASS-OCCUPYING LESIONS . . . 131 A. Hamartomas................. 131 1. Respiratory epithelial adenomatoid hamartoma .............. 131 2. Chondro-osseous respiratory epithelial adenomatoid hamartoma . . . . . . . 132 3. Nasal chondromesenchymal hamartoma. 132 69 69 75 76 76 76 77 77 77 79 85