Endoscopic Resection and Topical 5-Fluorouracil as an Alternative Treatment to Craniofacial Resection for the Management of Primary Intestinal-Type Sinonasal Adenocarcinoma

Abstract EN

Introduction.

Intestinal-type adenocarcinoma of the sinonasal tract is very rare and is responsible for less than 4% of tumours of the sinuses.

Craniofacial resection has been the mainstay of treatment for many years; however, techniques for endoscopic resection are constantly being developed.

Discussion.

The use of transnasal endoscopic resection (TER) and topical chemotherapy applications as an alternative to cranio-facial resection (CFR) is discussed.

TER offers advantages over CFR in terms of fewer intra-operative complications and an improved cosmetic outcome.

Survival and metastatic rates are similar between both procedures.

Patients with locally invasive tumours are better managed with CFR.

Topical applications of 5-Fluorouracil has been shown to be effective in increasing survival in patients with sino-nasal malignancy.

Conclusion.

Trans-nasal endoscopic resection and topical 5-Fluorouracil could potentially offer an acceptable alternative treatment to the standard of cranio-facial resection.

This should be investigated in trials with a longer followup period than this paper in order to directly compare the two treatment modalities.