Analysis the long-term results of treatment of patients with malignant tumours of the paranasal sinuses and nasal cavity with necessary surgical component in retro- and prospective groups

Objective. To evaluate the long-term results of treatment of patients using surgical endoscopic method and classical

external accesses.

Materials and methods. Within the framework of the present study, the data of two groups of patients undergoing surgical treatment at the N. N. Aleksandrov NCC of Belarus were used and analysed. The first group, retrospective (70 patients), was treated using classical external accesses, both independently and as part of a combined or complex approach, in the period from 2009 to 2018. The second group, prospective (44 patients), underwent endoscopic endonasal surgical treatment from 2019 to 2022.

Results. The analysis of the long-term results of patients treated with endoscopic treatment (prospective group) and classical external access (retrospective group) showed their comparability. The overall one-year survival rate was

90.2 ± 4.6 % in the prospective group and 95.7 ± 2.4 % in the retrospective group, three-year survival rates were

69.0 ± 8.2 % and 74.3 ± 5.2 %, respectively (p = 0.892). The adjusted one-year survival rates were 97.4 ± 2.6 % and

98.5 ± 1.5 %, three-year survival rates were 76.8 ± 8.1 % and 80.6 ± 4.8 %, respectively (p = 0.939). Recurrence-free one- year survival was 90.2 ± 4.7 % in the prospective group and 81.0 ± 4.7 % in the retrospective group, three-year survival was 73.6 ± 7.2 % and 62.8 ± 5.9 %, respectively (p = 0.608).

Conclusion. Taking into account comparable oncological indicators of both groups, it should be noted that the application of the developed method of endoscopic endonasal surgical treatment of patients with malignant tumours of paranasal sinuses and nasal cavity is reasonable. This method allows to avoid disfiguring facial incisions, damage of the upper alveolar nerve and soft tissues depression of the cheek, which occur when removing the anterior wall of the maxillary sinus. The use of video endoscopic equipment with optics of different angles makes it possible to perform a more precise removal of the tumour under visual control in the pterygopalatina and infratemporalis fossae, the projection of the sinus sphenoidalis, the lamina cribrosa and other parts of the skull base. This significantly improves the functional and aesthetic result of surgical treatment without reducing its radicality.

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