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Acta Medica Medianae |
SURGICAL THERAPY OF THE MALIGN TUMORS OF THE NOSE
AND THE SINUS WITH A BRIEF REVIEW OF OUR PATIENT MATERIAL Misko ŽIVIĆ and Slavoljub KOSTIĆ
Clinic for Otorhinoluryngology of the Clinic Center, Niš
The malign tumors of the nose and of the paranasal sinus are usually recognized only at an advanced stage of the disease when the bone walls get eroded thus making a five years period of survival less than 50%. The lymph drainage is directed towards the submandibular, parotid and jugudigastric lymph nodes. Such tumors rarely give metastases of the neck as well as distant ones; however, their spawning to the surrounding vital structure of the head is frequent and it is the main cause of the lethal outcome. The most frequent tumor of the paranasal sinus is in the maxillary sinus followed by the one in the ethmoid labyrinth and the nose hollow. Regarding histology, the most frequent is the planocellular carcinoma (about 80%) while the other types are less frequent. Except in the initial stadium, the malign tumors of the paranasal sinuses are treated by the combined surgical and radiotherapy. The radical surgical intervention is first done later to be completed by the radiotherapy. The time between the operation and the radiotherapy should be maximally reduced due to the established bad results in the cases when this time interval was prolonged. The propagation in the skull base, the cavernous sinus, the pterygoid space, the nasopharynx and the inoperable neck nodes can be a relative counterindication for the surgical treatment. In some cases it is necessary to add the enucleation of the orbit or the combined craniofacial approach for the sake of removing the tumor. The disease recessives, regardless of whether the therapy was surgical or radiotherapy, occur in the first two years.
Key words: malign tumors, nose and sinus, principles of the surgical therapy |