Aims and Objectives
As part of an initiative by the European Rhinologic Society, a group of internationally recognised experts from many disciplines have been invited to contribute to an Advisory Board, which has considered the present knowledge and published evidence concerning endoscopic techniques in the management of tumours, both benign and malignant, affecting the nose, paranasal sinuses and adjacent skull base. The aims have been to consider endoscopic techniques in the context of existing techniques, to highlight areas where further high quality evidence is required and to consider ways in which this may be achieved. In undertaking this evidence based review, the authors have concentrated on those tumours subjected to endoscopic resection, which have most frequently been reported in the literature and as a consequence certain less common histologies have been omitted. Nonetheless similar principles may be applied in the endoscopic management of these rarer tumours.
A similar methodology has been used as for the European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) (1). However, the participants recognise that when considering a surgical technique, the ability to provide placebo-controlled randomised trials, ie levels I & II is compromised by ethical
considerations. Furthermore, the rarity of these tumours makes the acquisition of large cohorts difficult. Nonetheless, the group are cognisant of the necessity to critically examine what has been published in the light of evidence based recommendations and recognise that most series can only be considered
as providing evidence at level III & IV and recommendations at levels C & D.
A Medline review of the literature was performed to identify relevant contributions from 1966 onwards. More detail is given in the specific sections.
Small nasal hemangioma before and after removal:
Large angiofibroma on the left side of 25 years old man
Papilloma of the right nasal cavity
Dissection of Fossa pterygopalatina