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Tang et al. Mini-invasive Surg 2024;8:24 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2024.04

Review Open Access

The role of endoscopic endonasal surgery in the

management of sinonasal malignant tumors with
skull base involvement

1
1
Anthony Tang , Samuel Adida , Garret Choby 2 , Paul A. Gardner 3
1
University of Pittsburgh, School of Medicine, Pittsburgh, PA 15213, USA.
2
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
3
Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Correspondence to: Dr. Paul Gardner, Department of Neurological Surgery, University of Pittsburgh Medical Center, 200
Lothrop St, Pittsburgh, PA 15213, USA. E-mail: gardpa@upmc.edu
How to cite this article: Tang A, Adida S, Choby G, Gardner PA. The role of endoscopic endonasal surgery in the management of
sinonasal malignant tumors with skull base involvement. Mini-invasive Surg 2024;8:24. https://dx.doi.org/10.20517/2574-1225.
2024.04
Received: 12 Jan 2024 First Decision: 29 Aug 2024 Revised: 12 Sep 2024 Accepted: 8 Oct 2024 Published: 12 Oct 2024

Academic Editors: Ehab Hanna, Giulio Belli Copy Editor: Dong-Li Li Production Editor: Dong-Li Li

Abstract
Sinonasal malignant tumors (SNMTs) represent a rare and heterogeneous group of tumors. SNMTs often present
late which can lead to complex, patient-specific treatment decisions. Over the last two decades, endoscopic
endonasal surgery (EES) has become a more frequently utilized surgical approach to removing these tumors.
Increasingly, studies have compared the outcomes of this approach to traditional open approaches for different
SNMTs. Differences in histology and extent of invasion impact the utility of EES. Negative margins are critical for
improving survival; however, skull base involvement can add anatomical challenges for achieving negative margins
during EES. This paper reviews the literature on outcomes of EES for SNMTs with skull base involvement and
presents evidence supporting the utility of EES for select patients. EES is a safe and effective treatment in patients
with less invasive SNMTs or less aggressive histology and can provide patients with fewer complications and
morbidity than traditional open approaches. As such, it plays a key role in surgical management, providing either
sole access or a critical avenue for SNMT removal. EES plays a key role in the multimodal oncological approach to
the treatment of different SNMT histologies.

Keywords: Endoscopic endonasal surgery, sinonasal malignancies, sinonasal tumors, skull base invasion, skull base
involvement

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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