[Malignant tumors of the ethmoid sinuses. A homogeneous series of 41 cases operated on by mixed approaches].

A series of 41 malignant tumors including 31 adenocarcinomas invading the ethmoid sinuses were treated by a combined transcranial-transfacial approach. Management, by the same team, of these consecutive cases permitted to analyze the technical problems and the carcinologic results. Chemotherapy was given to 21 patients pre-operative followed by surgical resection by a combined transbasal and paralateronasal routes and then, by a post-operative radiotherapy. Post-operative complications were more frequent (52%) in case of reconstruction of the anterior skull base and especially with madroporic corals. In the other cases where the double dural closure was only packed with abdominal subcutaneous fat, the rate of post-operative problems was only 20%. Noticeably, infection at the cranial base was observed in 6 cases (4 cases needing a reoperation) with bone reconstruction and in none without reconstruction. Actuarial survival rate was 84% at 1 year, 53% at 3 years and 36% at 5 years whatever the pathology (whole series or subgroup of adenocarcinomas). Mortality is related to incidental problems (3 cases), another malignant primary disease (3 cases), metastasis (8 cases) and local recurrence (4 cases). A longer survival was observed in the group of patients without skull base invasion (survival rate 100%, 83%, 50% at 1, 3 and 5 years respectively).