Olfactory neuroblastoma: Our ten-year experience

The olfactory neuroblastoma is a malignant neuroectodermal tumor thought to originate from the olfactory membrane of the sinonasal tract. It is uncommon, representing approximately 2‐3% of sinonasal tract tumours, with a bimodal age distribution. The main presenting symptoms are unilateral nasal obstruction and epistaxis; less common manifestations include anosmia, headache, pain, excessive lacrimation and ocular disturbances. Craniofacial resection followed by radiotherapy is considered the gold standard of the treatment. It is actually recognized the feasibility of the endoscopic endonasal resection, eventually associated to a craniotomic approach, with respect of the oncological criteria of radicality. From 1999 to 2009, 30 patients were treated for olfactory neuroblastoma at the Universitary Hospital of Varese and Brescia (Italy). 27 patients underwent a pure endoscopic endonasal resection, whereas 3 patients were treated with cranioendoscopic technique. Adjuvant radiotherapy was performed in 60% of cases. Overall Survival, Disease Free Survival e Recurrence Free Survival after 5 years are rispectively of 100%, 93,7% ± 6,05% and 75,6% ± 11,0%. Rate of complications is about 16,6%. These results are comparable to the ones reached with the standard craniofacial resection and allow us to carry on our experience in performing the endoscopic technique for the treatment of olfactory neuroblstoma. Larger and longer studies are needed.