Orbital Preservation in Patients with Esthesioneuroblastoma

Marc W. Herr; Stacey T. Gray; Audrey B. Erman; William T. Curry; Daniel G. Deschler; Derrick T. Lin

doi:10.1055/s-0033-1338259

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base 2013; 74(03): 142-145
DOI: 10.1055/s-0033-1338259

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Orbital Preservation in Patients with Esthesioneuroblastoma

Authors

Marc W. Herr

¹Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary/Massachusetts General Hospital Cranial Base Center, Boston, Massachusetts, USA
Stacey T. Gray

¹Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary/Massachusetts General Hospital Cranial Base Center, Boston, Massachusetts, USA
Audrey B. Erman

²Department of Otolaryngology–Head and Neck Surgery, University of Arizona Cancer Center, Tucson, Arizona, USA
William T. Curry

³Department of Neurosurgery, Pappas Center for Neuro-oncology, Massachusetts General Hospital, Boston, Massachusetts, USA
Daniel G. Deschler

¹Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary/Massachusetts General Hospital Cranial Base Center, Boston, Massachusetts, USA
Derrick T. Lin

¹Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary/Massachusetts General Hospital Cranial Base Center, Boston, Massachusetts, USA

Abstract

Objectives Surgical resection in addition to adjuvant radiation with or without chemotherapy is the mainstay of treatment for esthesioneuroblastoma (ENB). However, management of patients with orbital involvement remains controversial. Historically, orbital exenteration has been advocated when there is evidence of periorbital invasion. Recently, the indications for orbital exenteration have become more selective and orbital preservation has been advocated. We report our experience with anterior craniofacial resection and orbital preservation in patients with ENB.

Design Retrospective review of all patients diagnosed with esthesioneuroblastoma who underwent traditional open anterior craniofacial resection at the Massachusetts General Hospital/Massachusetts Eye and Ear Infirmary Cranial Base Center from 1997 to 2008.

Results Sixteen patients were identified with a mean follow-up of 76 months. All patients underwent anterior craniofacial resection via an open approach and adjuvant proton beam radiation. Six of the 16 patients had evidence of either periorbital or lacrimal sac involvement at the time of surgery. All of these patients underwent periorbital resection to negative histologic margins with preservation of the orbit.

Conclusion In our study, patients with ENB and periorbital invasion—who were treated with anterior craniofacial resection and periorbital resection with orbital preservation—had no evidence of decreased survival. In all patients, negative histologic margins of the periorbital resection were achieved.

Keywords

esthesioneuroblastoma - anterior craniofacial resection - orbital preservation - skull base

Full Text

References

References
1 Berger L, Luc R, Richard D. L'esthésioneuroépithéliome olfactif. Bull Assoc Fr Etud Cancer 1924; 13: 410-421
2 Bhattacharyya N, Thornton AF, Joseph MP, Goodman ML, Amrein PC. Successful treatment of esthesioneuroblastoma and neuroendocrine carcinoma with combined chemotherapy and proton radiation. Results in 9 cases. Arch Otolaryngol Head Neck Surg 1997; 123 (1) 34-40
3 Dulguerov P, Allal AS, Calcaterra TC. Esthesioneuroblastoma: a meta-analysis and review. Lancet Oncol 2001; 2 (11) 683-690
4 Levine PA, Gallagher R, Cantrell RW. Esthesioneuroblastoma: reflections of a 21-year experience. Laryngoscope 1999; 109 (10) 1539-1543
5 Nishimura H, Ogino T, Kawashima M , et al. Proton-beam therapy for olfactory neuroblastoma. Int J Radiat Oncol Biol Phys 2007; 68 (3) 758-762
6 Simon JH, Zhen W, McCulloch TM , et al. Esthesioneuroblastoma: the University of Iowa experience 1978-1998. Laryngoscope 2001; 111 (3) 488-493
7 Ward PD, Heth JA, Thompson BG, Marentette LJ. Esthesioneuroblastoma: results and outcomes of a single institution's experience. Skull Base 2009; 19 (2) 133-140
8 Resto VA, Eisele DW, Forastiere A, Zahurak M, Lee DJ, Westra WH. Esthesioneuroblastoma: the Johns Hopkins experience. Head Neck 2000; 22 (6) 550-558
9 Ketcham AS, Chretien PB, Van Buren JM, Hoye RC, Beazley RM, Herdt JR. The ethmoid sinuses: a re-evaluation of surgical resection. Am J Surg 1973; 126 (4) 469-476
10 Sisson GA. Symposium: 3. Treatment of malignancies of paranasal sinuses. Discussion and summary. Laryngoscope 1970; 80 (6) 945-953
11 Harrison DFN. Problems in surgical management of neoplasms arising in the paranasal sinuses. J Laryngol Otol 1976; 90 (1) 69-74
12 Som ML. Surgical management of carcinoma of the maxilla. Arch Otolaryngol 1974; 99 (4) 270-273
13 Nichols AC, Chan AW, Curry WT, Barker FG, Deschler DG, Lin DT. Esthesioneuroblastoma: the massachusetts eye and ear infirmary and massachusetts general hospital experience with craniofacial resection, proton beam radiation, and chemotherapy. Skull Base 2008; 18 (5) 327-337
14 Lund VJ, Howard D, Wei W, Spittle M. Olfactory neuroblastoma: past, present, and future?. Laryngoscope 2003; 113 (3) 502-507
15 Weymuller Jr EA, Reardon EJ, Nash D. A comparison of treatment modalities in carcinoma of the maxillary antrum. Arch Otolaryngol 1980; 106 (10) 625-629
16 Perry C, Levine PA, Williamson BR, Cantrell RW. Preservation of the eye in paranasal sinus cancer surgery. Arch Otolaryngol Head Neck Surg 1988; 114 (6) 632-634
17 McCary SW, Levine PA, Cantrell RW. Preservation of the eye in the treatment of sinonasal malignant neoplasms with orbital involvment. A confirmation of the original treatise. Arch Otolaryngol Head Neck Surg 1996; 122 (6) 657-659
18 Essig GF, Newman SA, Levine PA. Sparing the eye in craniofacial surgery for superior nasal vault malignant neoplasms: analysis of benefit. Arch Facial Plast Surg 2007; 9 (6) 406-411
19 Imola MJ, Schramm Jr VL. Orbital preservation in surgical management of sinonasal malignancy. Laryngoscope 2002; 112 (8 Pt 1) 1357-1365