嗅神経芽細胞腫に対する経鼻内視鏡下腫瘍切除術症例の検討

小澤 宏之; 冨田 俊樹; 渡部 佳弘; 関水 真理子; 伊藤 文展; 猪狩 雄一; 斎藤 真; 佐藤 陽一郎; 戸田 正博; 小川 郁

doi:10.5981/jjhnc.43.1

Retrospective analysis of olfactory neuroblastoma cases treated with endoscopic endonasal approach

Hiroyuki Ozawa, Toshiki Tomita, Yoshihiro Watanabe, Mariko Sekimizu, Fumihiro Ito, Yuichi Ikari, Shin Saito, Yoichiro Sato, Masahiro Toda, Kaoru Ogawa

Author information

Hiroyuki Ozawa
Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine
Toshiki Tomita
Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine
Yoshihiro Watanabe
Department of Otolaryngology, Head and Neck Surgery, Saiseikai Central Hospital
Mariko Sekimizu
Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine
Fumihiro Ito
Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine
Yuichi Ikari
Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine
Shin Saito
Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine
Yoichiro Sato
Department of Otolaryngology, Head and Neck Surgery, Kawasaki Municipal Hospital
Masahiro Toda
Department of Neurosurgery, Keio University School of Medicine
Kaoru Ogawa
Department of Otolaryngology, Head and Neck Surgery, Keio University School of Medicine

Keywords: Olfactory neuroblastoma, Endoscopic endonasal skull base surgery, Skull base reconstruction

JOURNAL FREE ACCESS

2017 Volume 43 Issue 1 Pages 1-7

DOI https://doi.org/10.5981/jjhnc.43.1

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Abstract

We retrospectively reviewed nine cases of olfactory neuroblastoma in Keio University School of Medicine from 2010 to 2015. The surgical approach was the endoscopic endonasal approach, either alone or in combination with craniotomy, performed by a team of head and neck surgeons and a neurosurgeon. The distribution of patients according to the modified Kadish classification （A/B/C/D） and Dulguerov classification （T1/T2/T3/T4） was 1/4/4/0 and 1/4/2/2. Tumors of six cases were removed by the endoscopic endonasal approach alone; three cases needed craniotomy to resect intra-dual tumors. Three-layered skull base reconstruction using fascia, pericranial flap and nasoseptal flap was used for five cases. None of the cases experienced cerebrospinal fluid leakage postoperatively. Seven patients received postoperative radiotherapy. Three cases experienced tumor recurrence, and underwent salvage surgery or radiotherapy. All cases remained alive, though the average observation time was less than 3 years. Recent reports have demonstrated that the endoscopic endonasal approach has a comparable control rate to the open approach for olfactory neuroblastoma. We believe that endoscopic endonasal skull base surgery should play a key role in the treatment of olfactory neuroblastoma in the years ahead.

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