Abstract
Thirty consecutive cases of midline anterior craniofacial procedures for the treatment
of malignant neoplasms arising from the paranasal sinuses were reviewed. Posterior
and lateral base craniofacial procedures were specifically excluded. This review compares
the results, in terms of survival and major complication rate, between en bloc and
piecemeal resections. The average follow-up was 4 years and 3 months. Sixteen patients
were treated with an en bloc resection. The major complication rate was 31%. One-year
survival rate was 94% for the en bloc resection group, 67% for patients with positive
margins, and 100% for patients with clear margins. Three-year survival for en bloc
resection dropped to 56, 33, and 67%, respectively. Fourteen patients were treated
with piecemeal resections. The major complication rate was 21%. One-year survival
rate was 83% for the piecemeal resection group, 60% for patients with positive margins,
and 100% for patients with clear margins. Three-year survival dropped to 70, 60, and
80%, respectively. Although it is considered desirable to obtain an en bloc resection
in some craniofacial procedures, we conclude that a piecemeal resection is a viable
alternative in situations where an en bloc procedure is difficult to obtain safely.
