Experience with endonasal endoscopic resection of non-angiofibroma sinonasal and orbital apex vascular tumours

Abstract

Background: Endoscopic endonasal approach for the management of sinonasal inflammatory pathologies and tumours has been a widely accepted procedure and used for many years. The aim of the study is to assess effectiveness and safety of endonasal endoscopic resection in removal of sinonasal vascular tumours and to evaluate outcomes and clinical behaviour of different subtypes with review of the literature. Material and Methods: A retrospective review of the patients treated for sinonasal and orbital apex vascular tumour was performed. Patient’s demographics, surgical approaches, complications, histopathological results, and long-term outcomes were evaluated. Results: Twenty-two patient included in this study. The mean tumour size ranged from 6 to 100 mm (30.45 ± 22.7 mm). Histopathological examination revealed 8 (36%) capillary hemangioma, 6 (33.3%) cavernous hemangioma, 2 (12%) mixed hemangioma, and 2(12%) vascular leiomyomas. Three (13.6%) patients were diagnosed as glomangiopericytoma and remaining 1 (4.4%) was angiosarcoma. Only in 1 patient with recurrent glomangiopericytoma preoperative embolization were needed. Five patients had preoperative biopsy in office settings. The mean follow-up was 72.9 (± 53.71) months. The recurrence was observed in 3 (13.6%) patients. Conclusion: Endonasal endoscopic approach for sinonasal vascular tumours is a safe and reliable method for resection. Our study suggested location of the tumour is more important than the size to achieve complete resection. Long-term follow-ups are important to detect recurrences early even after macroscopically complete resections.

Keywords

• sinonasal tumours
• lobular capillary hemangioma
• cavernous hemangioma
• glomangiopericytoma
• angiosarcoma
• endoscopic endonasal surgery