Introduction: Esthesioneuroblastoma or olfactory neuroblastoma is a rare malignant neoplasm of
the nasal cavity and paranasal sinuses. An optimal treatment regimen remains elusive
with surgery, radiation, and chemotherapy all being used in different combinations
by different institutions. The most common surgical treatment is craniofacial resection.
This report demonstrates our approach to resection of these tumors using a subcranial
approach.
Methods: Retrospective review of patient data obtained from the University of Michigan Skull
Base Tumor registry.
Results: Fifteen patients were identified and the pathology confirmed to be esthesioneuroblastoma.
No patients presented with Kadish stage A, 11 with stage B, and 4 with stage C disease.
All patients underwent subcranial resection. The mean follow-up was 6.5 years and
4 patients were lost to follow up. Survival rates for 5 and 10 years were both 100%.
Seven patients had recurrences (5 local and 2 regional recurrences). Complications
included pneumocephalus (3), CSF leak (3), epiphora (3), diplopia (2), hydrocephalus
(1), and wound infection (1).
Conclusion: Esthesioneuroblastoma is a rare tumor that is best managed by complete tumor resection
with postoperative radiation. The subcranial approach is a valuable alternative to
traditional craniofacial approaches that minimizes facial scarring and frontal lobe
retraction.
