Removal of large benign cephalonasal tumours by transbasal surgery combined with endonasal endoscopic sinus surgery and neuronavigation.

OBJECTIVE: A retrospective study has been made of the transbasal and endonasal endoscopic sinus surgery of 29 cases with cephalonasal tumours treated in this hospital since 2001 in order to evaluate their clinical outcome.

METHODS: There were 18 male and 11 female patients aged between 4 and 55 years (mean 32.2 years). The tumours were located in the anterior or middle skull base, the paranasal sinus, and/or the nasal cavity. All patients underwent surgical resection via the transbasal surgery technique before endonasal endoscopic sinus surgery was performed. In 20 cases neuronavigation was used in addition to locate the tumour and adjoining structures.

RESULTS: Twenty-seven cases had a complete removal of the tumour whilst the others had only a subtotal resection. None of the patients died as a result of the operation. A follow-up study of 7 months to 4 years aided by CT and MRI showed no evidence of recurrence in 26 out of the 29 patients. The three other patients had to undergo a second operation or postoperative radiotherapy to treat a recurrence. The long-term postoperative sequelae included hypoosmia, ophthalmoplegia, paralysis of the 6th cranial nerve or hypopsia in 8 patients.

CONCLUSION: Transbasal surgery combined with endonasal endoscopic sinus surgery and neuronavigation is a particularly useful technique for resecting large benign cephalonasal tumours.