Innovative Approach to Surgical Treatment for Locally Advanced Cancer of Paranasal Sinus and Nasal Cavity

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Abstract

Background. Despite the rapid oncology development, the problem of surgical treatment for locally advanced tumors of the paranasal sinus and nasal cavity is still relevant. The search and development of ways to improve the surgical approach, including modern endovascular methods, appears necessary. Aims — development and evaluation of the effectiveness of an innovative approach to the surgical treatment of malignant tumors of the nasal cavity and paranasal sinus with superselective intra-arterial embolization as a preparatory stage. Materials and methods. The study is based on the treatment outcomes of 52 patients with cancer of the nasal cavity and paranasal sinus. The main group included 21 patients receiving treatment with our developed approach including preoperative superselective intra-arterial embolization as a preparatory stage for surgical treatment. The control group included 31 patients receiving standard surgical treatment with traditional ligation of the external carotid artery at the first stage. Estimation of the amount of intraoperative blood loss with gravimetric analysis was considered the primary endpoint of the study. Post-embolization syndrome manifestations were analyzed by evaluating the pain intensity with a visual analogue scale and thermometry. Results. Intraoperative blood loss in patients of the main group varied from 100 to 400 ml, being on average 231.9±100.58 ml. In the control group, the blood loss varied from 300 ml to 1000 ml, on average 630.97±190.23. The data analysis proved demonstratively the effectiveness of the developed approach to surgical treatment of locally advanced tumors of the nasal cavity and paranasal sinus, since it statistically significantly reduced the amount of intoperative blood loss (p < 0.005). Conclusions. Our developed approach to the treatment for malignant tumors of the paranasal sinus and nasal cavity optimized the results of surgical treatment and statistically significantly reduced the amount of intoperative blood loss, compared to the traditional ligation of the external carotid artery, from 630.97±190.23 to 231.9±100.58 ml (p < 0.005), with minimal manifestations of post-embolization syndrome.

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About the authors

Oleg I. Kit

National Medical Research Centre for Oncology

Email: kit@aaanet.ru
ORCID iD: 0000-0003-3061-6108
SPIN-code: 1728-0329

MD, PhD, Professor, Corresponding Member of the RAS

Russian Federation, 63, 14th liniya, Rostov on Don, 344029

Igor V. Reshetov

I.M. Sechenov First Moscow State Medical University; Federal Scientific and Clinical Center for Specialized Types of Medical Care and Medical Technologies of the Federal Medical and Biological Agency

Email: reshetoviv@mail.ru
ORCID iD: 0000-0002-0909-6278
SPIN-code: 3845-6604

MD, PhD, Professor, Academician of the RAS

Russian Federation, 8-2, Trubetskaya street, Moscow, 119991; 28, Walnut Boulevard, Moscow

Marina A. Engibaryan

National Medical Research Centre for Oncology

Author for correspondence.
Email: mar457@yandex.ru
ORCID iD: 0000-0001-7293-2358
SPIN-code: 1764-0276

 MD, PhD

Russian Federation, 63, 14th liniya, Rostov on Don, 344029

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Supplementary files

Supplementary Files
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1. Fig. 1. The volume of surgical blood loss in patients of the main group (n = 21)

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2. Fig. 2. The volume of surgical blood loss in patients of the control group (n = 31)

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