Endoscopic surgery versus various open approaches in esthesioneuroblastoma: a systematic review of the literature

ObjectiveEsthesioneuroblastoma (ENB) is treated using several open surgery (OpS) methods, with or without endoscopic assistance ( ± E-ass) or endoscopic surgery (ES). This systematic review compared the results with various approaches using OpS ± E-ass and ES.Data sourcesA systematic PubMed/Medline...

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Main Authors: Michael Koch, Matthias Balk, Sven Schlaffer, Moritz Allner, Heinrich Iro, Sarina K. Müller
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1512771/full
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author Michael Koch
Matthias Balk
Sven Schlaffer
Moritz Allner
Heinrich Iro
Sarina K. Müller
author_facet Michael Koch
Matthias Balk
Sven Schlaffer
Moritz Allner
Heinrich Iro
Sarina K. Müller
author_sort Michael Koch
collection DOAJ
description ObjectiveEsthesioneuroblastoma (ENB) is treated using several open surgery (OpS) methods, with or without endoscopic assistance ( ± E-ass) or endoscopic surgery (ES). This systematic review compared the results with various approaches using OpS ± E-ass and ES.Data sourcesA systematic PubMed/Medline search was conducted for the period 1990–2023.Review methodsKeywords were “esthesioneuroblastoma” or “olfactory neuroblastoma” and “surgery,” “surgical,” “resection,” “approach,” “open,” and “endoscopic.” Studies/case series and case reports were included. Results with OpS ± E-ass (stratified into various approaches) were compared with ES results. Parameters assessed were follow-up period, frequencies of advanced tumor stages, Hyams grade III–IV tumors, negative margins/gross total resection, postoperative complication rates, preoperative/postoperative radiation therapy/chemotherapy, primary tumor progression, and frequency of/time to first recurrence.ResultsA total of 88 studies/case series or single cases/case reports (SC/CR) with results after OpS ± E-ass (850 cases) and 84 with results after ES (584 cases) were included. Compared with OpS ± E-ass, after ES, the average follow-up was significantly shorter (p=0.048) and mean crude disease-free survival (DFS) significantly better (studies/case series, p=0.0001; SC/CR, p=0.001). Compared with OPS ± E-ass, after ES, significantly fewer advanced tumors were treated (studies/case series, p=0.0001; SC/CR, p=0.001); negative margins were significantly less frequent (studies/case series, p=0.009); surgical complications were less frequent (studies/case series, p=0.022); less radiation therapy (studies/case series, p=0.043) and/or chemotherapy (SC/CR, p=0.022) was performed; and recurrences were noted significantly less often (studies/case series, p=0.0001; SC/CR, p=0.034). Among OpS ± E-ass, craniofacial resection ± E-ass showed most significant differences from ES.ConclusionsThese data support that ES can be regarded as the surgical method of first choice in less advanced ENB but may also be a good choice in carefully selected advanced ENB.
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spelling doaj-art-ff07c0b4ebbf4b1aadaaf649b32f5a642025-08-20T03:05:52ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15127711512771Endoscopic surgery versus various open approaches in esthesioneuroblastoma: a systematic review of the literatureMichael Koch0Matthias Balk1Sven Schlaffer2Moritz Allner3Heinrich Iro4Sarina K. Müller5Department of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, GermanyDepartment of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, GermanyDepartment of Neurosurgery, University of Erlangen–Nuremberg, Erlangen, GermanyDepartment of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, GermanyDepartment of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, GermanyDepartment of Otorhinolaryngology and Head and Neck Surgery, University of Erlangen–Nuremberg, Erlangen, GermanyObjectiveEsthesioneuroblastoma (ENB) is treated using several open surgery (OpS) methods, with or without endoscopic assistance ( ± E-ass) or endoscopic surgery (ES). This systematic review compared the results with various approaches using OpS ± E-ass and ES.Data sourcesA systematic PubMed/Medline search was conducted for the period 1990–2023.Review methodsKeywords were “esthesioneuroblastoma” or “olfactory neuroblastoma” and “surgery,” “surgical,” “resection,” “approach,” “open,” and “endoscopic.” Studies/case series and case reports were included. Results with OpS ± E-ass (stratified into various approaches) were compared with ES results. Parameters assessed were follow-up period, frequencies of advanced tumor stages, Hyams grade III–IV tumors, negative margins/gross total resection, postoperative complication rates, preoperative/postoperative radiation therapy/chemotherapy, primary tumor progression, and frequency of/time to first recurrence.ResultsA total of 88 studies/case series or single cases/case reports (SC/CR) with results after OpS ± E-ass (850 cases) and 84 with results after ES (584 cases) were included. Compared with OpS ± E-ass, after ES, the average follow-up was significantly shorter (p=0.048) and mean crude disease-free survival (DFS) significantly better (studies/case series, p=0.0001; SC/CR, p=0.001). Compared with OPS ± E-ass, after ES, significantly fewer advanced tumors were treated (studies/case series, p=0.0001; SC/CR, p=0.001); negative margins were significantly less frequent (studies/case series, p=0.009); surgical complications were less frequent (studies/case series, p=0.022); less radiation therapy (studies/case series, p=0.043) and/or chemotherapy (SC/CR, p=0.022) was performed; and recurrences were noted significantly less often (studies/case series, p=0.0001; SC/CR, p=0.034). Among OpS ± E-ass, craniofacial resection ± E-ass showed most significant differences from ES.ConclusionsThese data support that ES can be regarded as the surgical method of first choice in less advanced ENB but may also be a good choice in carefully selected advanced ENB.https://www.frontiersin.org/articles/10.3389/fonc.2025.1512771/fullendoscopictranscranialcraniofacialtransfacialopensurgery
spellingShingle Michael Koch
Matthias Balk
Sven Schlaffer
Moritz Allner
Heinrich Iro
Sarina K. Müller
Endoscopic surgery versus various open approaches in esthesioneuroblastoma: a systematic review of the literature
Frontiers in Oncology
endoscopic
transcranial
craniofacial
transfacial
open
surgery
title Endoscopic surgery versus various open approaches in esthesioneuroblastoma: a systematic review of the literature
title_full Endoscopic surgery versus various open approaches in esthesioneuroblastoma: a systematic review of the literature
title_fullStr Endoscopic surgery versus various open approaches in esthesioneuroblastoma: a systematic review of the literature
title_full_unstemmed Endoscopic surgery versus various open approaches in esthesioneuroblastoma: a systematic review of the literature
title_short Endoscopic surgery versus various open approaches in esthesioneuroblastoma: a systematic review of the literature
title_sort endoscopic surgery versus various open approaches in esthesioneuroblastoma a systematic review of the literature
topic endoscopic
transcranial
craniofacial
transfacial
open
surgery
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1512771/full
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