Endoscopic Endonasal Resection of Esthesioneuroblastoma: A Multicenter Study

Introduction: Esthesioneuroblastoma is a malignant tumor arising from the neuroepithelium of the olfactory cleft. Endoscopic resection techniques are gaining popularity. However, the efficacy of these techniques is unknown. Here, we report our multi-institutional experience with endoscopic resection of esthesioneuroblastomas.

Patients and Interventions: Twenty-two patients, 15 men and 7 women, who were operated at the University of Pittsburgh Medical Center and the University of Miami, were included in the study. Mean age was 54 years (15 to 79 yrs). Nineteen patients received primary endoscopic endonasal anterior skull base resection. Of these, the modified Kadish stage was A in 2, B in 11, C in 5, and D in 1 patient. Three patients were revision surgeries for recurrent tumors.

Results: Complete resection and negative intraoperative resection margins were achieved endoscopically in 16 of the primary cases. All patients tolerated the endoscopic procedure without meningitis. There were 3 transient CSF leaks. Mean follow-up period for the primarily treated cases was 31.3 months (5 to 104 mos); all were disease-free at the most recent follow-up.

Conclusion: In experienced hands and carefully selected patients, endoscopic resection of esthesioneuroblastoma provides adequate exposure for margin assessment as well as reliable reconstruction of the anterior skull defect.