Rigid endoscopy in minimally invasive therapy of tumours of the paranasal sinuses and skull base

The use of rigid endoscopes in paranasal sinuses, nasopharynx and skull base surgery has extended and diversified, specifically for the treatment of malignant lesions of the nose and paranasal sinuses. We have endoscopically treated 33 patients with tumours of the skull base, paranasal sinuses and nasopharynx during the last 8 years (five patients with juvenile nasopharyngeal angiofibromas and 28 patients with various malignant tumours and T-classification). Endoscopic tumour surgery can be performed in patients of all age groups, even in the first days of life, using endoscopes of different diameters. Cosmetic results are excellent; there is no disfiguration of the face. Functional results are also excellent in terms of: organ preservation, minimal morbidity and rapid postoperative recovery and short hospitalisation. All these factors are essential for the patient's duality of life. Limitations of this technique, however, are found at the anatomical borders of the paranasal sinuses, when a tumour extensively infiltrates the orbit, the surrounding soft-tissue and skull base. However, very aggressive and extensive endoscopic surgery can be performed, e.g. removal of bone and dura of the anterior skull base, as well as resection of the periorbit and lateral nasal wall with the turbinates. Our results, with only a few recurrences after endoscopic endonasal tumour surgery, encourage us to use this procedure in selected cases as a reliable alternative to other techniques.