Sinonasal and Skull Base Pathologies: Personalized Management Based on Radiological and Biological Fingerprint

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy and Drug Delivery".

Deadline for manuscript submissions: 10 October 2024 | Viewed by 3481

Special Issue Editors


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Guest Editor
Otorhinolaryngology and Skull Base Center, AP-HP, Hôpital Lariboisière, 75010 Paris, France
Interests: head and neck surgery; endonasal endoscopic surgery; skull base surgery; rhinology; sinonasal cancer; skull base tumors

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Guest Editor
Department of Otorhinolaryngology Head and Neck Surgery, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, University of Insubria, 21100 Varese, Italy
Interests: head and neck surgery; endonasal endoscopic surgery; skull base surgery; rhinology; sinonasal cancer; skull base tumors

Special Issue Information

Dear Colleagues,

It is our great pleasure to invite you to contribute to this Special Issue of the Journal of Personalized Medicine.

In the past few decades, our understanding of sinonasal pathologies and skull base lesions has improved. As a result, many inflammatory sinonasal lesions involving the skull base may now be effectively treated endoscopically, and several benign and malignant tumors can be approached using different personalized surgical techniques. Nevertheless, several limits are still present and, for some rare histologies, the correct management is still open to debate.

In this Special Issue, we aim to highlight the most recent advancements in this field, focusing our attention on the personalized management of different sinonasal and skull base pathologies.

Dr. Alessandro Vinciguerra
Dr. Mario Turri-Zanoni
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Personalized Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • sinonasal tumors
  • skull base tumors
  • rhinology
  • multidisciplinary cancer treatment
  • endoscopic surgery
  • transnasal approach
  • target therapy
  • inflammatory sinonasal pathologies
  • chronic rhinosinusitis
  • nasal polyps

Published Papers (4 papers)

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Research

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11 pages, 2258 KiB  
Article
Enhancing Frontal Sinus Surgery: Assessing the Long-Term Impact of Free Grafts and Flaps in Draf III Procedures
by Argyro Leventi, Vasileios Chatzinakis, Georgia Evangelia Papargyriou and Christos Georgalas
J. Pers. Med. 2024, 14(4), 396; https://doi.org/10.3390/jpm14040396 - 9 Apr 2024
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Abstract
The frontal sinus medial drainage —Draf Type III (modified endoscopic Lothrop) procedure, has become a cornerstone in frontal sinus surgery over the last three decades. Despite its widespread acceptance, challenges such as restenosis and neo-ostium closure persist, prompting the exploration of various preventive [...] Read more.
The frontal sinus medial drainage —Draf Type III (modified endoscopic Lothrop) procedure, has become a cornerstone in frontal sinus surgery over the last three decades. Despite its widespread acceptance, challenges such as restenosis and neo-ostium closure persist, prompting the exploration of various preventive techniques. In this retrospective study, we analyzed data from 111 patients who underwent the Draf III procedure between November 2015 and November 2023, with a mean follow-up period of 3 years and 11 months. Approximately two-thirds of patients (64%) had undergone previous sinus surgery and 16% a previous Draf III. Over half of the patients had inflammatory conditions, with the majority being chronic rhinosinusitis with nasal polyps (CRSwNP) (46%), while 15% were diagnosed with malignant sinonasal tumors, and 23% with benign sinonasal tumors, of which the commonest was osteoma, accounting for 14 cases. The mean follow-up period was 3 years and 11 months. We focused on evaluating the efficacy of mucosal flaps and free grafts in preventing neo-ostium closure. Although it appears that there is no statistically significant correlation between flap usage and the need for revision surgery or ostium patency maintenance overall, subgroup analysis highlighted the benefits of flap reconstruction in patients with chronic rhinosinusitis with nasal polyps. In this subgroup, the use of flaps or grafts reduced the rate of neo-ostium stenosis from 20% to 0% (p < 0.05). Overall revision rate was 11.7%—however this was 8% in patients without acute inflammation at the time of surgery and went up to 31% in the presence of pus in the frontal recess (p = 0.02). This study contributes to the existing literature by providing insights into long-term outcomes, the enduring effectiveness of interventions in frontal sinus surgery, and especially the importance of taking into account the underlying pathology when assessing long-term outcomes. Full article
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10 pages, 4345 KiB  
Article
Iatrogenic Cerebrospinal Fluid Leak in Endoscopic Sinus Surgery: Topographical Map and Influence of Skull Base Asymmetry
by Alessandro Vinciguerra, Isabelle Dohin, Antonio Daloiso, Francesco Boaria, Morgane Marc, Benjamin Verillaud, Florian Chatelet and Philippe Herman
J. Pers. Med. 2024, 14(3), 226; https://doi.org/10.3390/jpm14030226 - 21 Feb 2024
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Abstract
Background: Iatrogenic cerebrospinal fluid leak (iCSF-L) is a major complication of endonasal surgeries whose occurrence is always a potential adverse event due to anatomical variation/asymmetry of the skull base (SB). The aim of this manuscript is to provide a topographical map of iCSF-L [...] Read more.
Background: Iatrogenic cerebrospinal fluid leak (iCSF-L) is a major complication of endonasal surgeries whose occurrence is always a potential adverse event due to anatomical variation/asymmetry of the skull base (SB). The aim of this manuscript is to provide a topographical map of iCSF-L and to investigate the role of SB asymmetry in iCSF-L occurrence. Methods: In this retrospective study, the location of iCSF-L dural defect was studied and compared to patients affected by spontaneous and post-traumatic CSF-L. Considering only iCSF-L, after having collected the SB asymmetry data, the Keros, Gera, distance of the anterior ethmoidal artery from the SB, frontal sinus pneumatization, and Thailand–Malaysia–Singapore score classifications were compared to a control group of patients. Results: A total of 153 CSF-Ls (103 spontaneous, 37 iatrogenic, and 13 traumatic) were included. A significant association was noted (p < 0.001) between the nature of the CSF-L and the areas involved. Considering iCSF-Ls, only the Gera classification was significantly different (p < 0.05) and the most reliable in predicting the risk of dural transgression (AUC = 0.719). Conclusions: ICSF-Ls present peculiar regional SB involvement with the cribriform plate, with the ethmoidal roof being the most involved. After having assessed the asymmetry of the SB, the Gera classification was the most reliable one. Full article
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Review

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13 pages, 3248 KiB  
Review
Personalized Approach to Olfactory Neuroblastoma Care
by David K. Lerner and James N. Palmer
J. Pers. Med. 2024, 14(4), 423; https://doi.org/10.3390/jpm14040423 - 16 Apr 2024
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Abstract
Olfactory neuroblastoma (ONB) is an uncommon neuroendocrine malignancy arising from the olfactory neuroepithelium. ONB frequently presents with nonspecific sinonasal complaints, including nasal obstruction and epistaxis, and diagnosis can be obtained through a combination of physical examination, nasal endoscopy, and computed tomography and magnetic [...] Read more.
Olfactory neuroblastoma (ONB) is an uncommon neuroendocrine malignancy arising from the olfactory neuroepithelium. ONB frequently presents with nonspecific sinonasal complaints, including nasal obstruction and epistaxis, and diagnosis can be obtained through a combination of physical examination, nasal endoscopy, and computed tomography and magnetic resonance imaging. Endoscopic resection with negative margins, with or without craniotomy, as necessary, is the standard of care for definitive treatment of ONB. Regional metastasis to the neck is often detected at presentation or may occur in a delayed fashion and should be addressed through elective neck dissection or radiation. Adjuvant radiotherapy should be considered, particularly in the case of high grade or tumor stage, as well as positive surgical margins. Systemic therapy is an area of active investigation in both the neoadjuvant and adjuvant setting, with many advocating in favor of induction chemotherapy for significant orbital or intracranial involvement prior to surgical resection. Various targeted immunotherapies are currently being studied for the treatment of recurrent or metastatic ONB. Prolonged locoregional and distant surveillance are indicated following definitive treatment, given the tendency for delayed recurrence and metastasis. Full article
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Other

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17 pages, 11716 KiB  
Systematic Review
A Pathophysiological Approach to Spontaneous Orbital Meningoceles: Case Report and Systematic Review
by Piergiorgio Gaudioso, Elia Biancoli, Veronica Battistuzzi, Stefano Concheri, Tommaso Saccardo, Sebastiano Franchella, Giacomo Contro, Stefano Taboni, Elisabetta Zanoletti, Francesco Causin, Lorena Nico, Joseph Domenico Gabrieli, Roberto Maroldi, Piero Nicolai and Marco Ferrari
J. Pers. Med. 2024, 14(5), 465; https://doi.org/10.3390/jpm14050465 - 28 Apr 2024
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Abstract
Background: Spontaneous orbital cephaloceles are a rare condition. The purpose of this study is to provide a description of a clinical case and to carry out a systematic literature review. Methods: A systematic review of the English literature published on the Pubmed, Scopus, [...] Read more.
Background: Spontaneous orbital cephaloceles are a rare condition. The purpose of this study is to provide a description of a clinical case and to carry out a systematic literature review. Methods: A systematic review of the English literature published on the Pubmed, Scopus, and Web of Science databases was conducted, according to the PRISMA recommendations. Results: A 6-year-old patient was admitted for right otomastoiditis and thrombosis of the sigmoid and transverse sinuses, as well as the proximal portion of the internal jugular vein. Radiological examinations revealed a left orbital mass (22 × 14 mm) compatible with asymptomatic orbital meningocele (MC) herniated from the superior orbital fissure (SOF). The child underwent a right mastoidectomy. After the development of symptoms and signs of intracranial hypertension (ICH), endovascular thrombectomy and transverse sinus stenting were performed, with improvement of the clinical conditions and reduction of the orbital MC. The systematic literature review encompassed 29 publications on 43 patients with spontaneous orbital MC. In the majority of cases, surgery was the preferred treatment. Conclusions: The present case report and systematic review highlight the importance of ICH investigation and a pathophysiological-oriented treatment approach. The experiences described in the literature are limited, making the collection of additional data paramount. Full article
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