POSSIBILITIES OF SURGICAL APPROACHES TO REMOVE TUMORS OF THE PARANASAL SINUSES THAT HAVE SPREAD TO THE BASE OF THE SKULL
A.M. Orozalieva, B.D. Shalabaev, Ali Zeshan, Zeeshan Majeed
Introduction. Surgical treatment of tumors of the paranasal sinuses that have spread to the base of the skull, include those with invasion into the cranial fossa, belonging to a severe and often dangerous category and fraught with serious complications. Therefore, the choice of a surgical approach to remove such tumors is of particular importance.
The aim. To make a comparative analysis of the possibilities of surgical approaches for lateral rhinotomy with continuation to the frontal sinuses, extended rhinotomy, and Lauers-Balon in developing an optimal treatment for various variants of the spread of tumors at the base of the skull.
Materials and methods. To determine the extent of the tumor and justify the choice of surgical access, an examination was carried out using computed tomography according to the methods described in the literature.
We considered clinical material, including the results of surgical treatment of 41 patients with tumors and tumor-like diseases of the maxillofacial region with spread to the structures of the base of the skull.
Results. Among the 41 patients selected T-shaped approach and extended lateral rhinotomy were done. In patients with tumors present in the frontal sinus and ethmoid labyrinth with extensions to anterior cranial fossa T-shaped approach showed a good results, while 32 cases with tumor of jaw the procedure of extended lateral rhinotomy showed good visual access and good results.
Conclusions. The conclusion of this work is that for the removal of the cancer or masses from the ethmoid labyrinth and frontal sinuses with extension to the anterior cranial fossa the T-shaped approach combine with shortened
lateral rhinotomy can be performed. Extended lateral rhinomaxillotomy can be the option for the removal of cancers of upper jaw and paramaxillary formations with invasion into the basal of skull.
For the prevention of meningocerebral completion in dura matter defect our method of plastic closer of dural defect is commendable.
Key words: tumors of the paranasal sinuses with extension to the base of the skull, surgical treatment of tumors of the base of the skull.