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Article ; Online: Updates in management strategies of locally advanced sinonasal malignancy.

Yaniv, Dan / Su, Shirley Y

Current opinion in otolaryngology & head and neck surgery

2023 Volume 31, Issue 1, Page(s) 39–44

Abstract: Purpose of review: Sinonasal tumors are a rare heterogenous group of pathologies with poor prognosis. In recent years better definition and understanding of histology, molecular classification, biological behavior and advances in therapy have resulted ... ...

Abstract	Purpose of review: Sinonasal tumors are a rare heterogenous group of pathologies with poor prognosis. In recent years better definition and understanding of histology, molecular classification, biological behavior and advances in therapy have resulted in improved prognosis. The purpose of this review is to give an updated summary of the recent advances in treatment, and where relevant, with references to pathology classifications. Recent findings: Recent publications highlight the role of induction chemotherapy and advances in radiotherapy in advanced cancers. In addition, better understanding of genomics and histology specific treatment algorithms has led to more tailored treatment approaches. The role of immunotherapy and targeted therapy are yet to be explored. Summary: This review gives an up to date summary of the advances in contemporary management strategies for locally advanced sinonasal malignancies and can serve as a guide for researchers and clinicians.
MeSH term(s)	Humans ; Algorithms ; Genomics ; Immunotherapy ; Neoplasms ; Paranasal Sinuses/pathology
Language	English
Publishing date	2023-02-27
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	1232518-1
ISSN	1531-6998 ; 1068-9508
ISSN (online)	1531-6998
ISSN	1068-9508
DOI	10.1097/MOO.0000000000000866
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Article ; Online: Current status of sinonasal cancer survivorship care.

Han, Albert Y / Nader, Marc-Elie / Lam, Keng / Su, Shirley Y

Head & neck

2023 Volume 45, Issue 9, Page(s) 2458–2468

Abstract: Sinonasal cancer is a heterogeneous orphan disease of diverse histologies, each with distinct clinical, oncologic, and toxicity profiles. Because of the comparative rarity of these cancers, sinonasal cancers are treated as a grouped diagnosis despite ... ...

Abstract	Sinonasal cancer is a heterogeneous orphan disease of diverse histologies, each with distinct clinical, oncologic, and toxicity profiles. Because of the comparative rarity of these cancers, sinonasal cancers are treated as a grouped diagnosis despite their clinical and biological heterogeneity. Multimodality treatment with a combination of surgery, chemotherapy, and/or radiotherapy is the standard-of-care for advanced-stage patients but there are few surveillance or follow-up practice guidelines or formalized survivorship care pathways. A scoping literature review was conducted via PubMed, EMBASE, and Google Scholar. A total of 112 studies were included, which were grouped along the following topics: surveillance, second primary tumors, quality of life, and symptom burden. Sinonasal cancer tends to exhibit a higher rate of local failure and occur in a delayed fashion compared to mucosal malignancies of the head and neck. Moreover, the site of failure and time-varying risk of recurrence is histology-specific. Following multimodality treatment of the skull base, patients may experience endocrine, visual, auditory, sinonasal, olfactory, and neurocognitive deficits, as well as psychosocial impairments that impact multiple physical and neuropsychological domains, resulting in diminished quality of life. Sinonasal cancer patients would benefit from tailored, histology-specific survivorship programs to address the recurrence, second primary, and functional impairments resulting from disease and treatment toxicity.
MeSH term(s)	Humans ; Survivorship ; Quality of Life ; Cancer Survivors ; Paranasal Sinus Neoplasms/pathology ; Combined Modality Therapy
Language	English
Publishing date	2023-07-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	645165-2
ISSN	1097-0347 ; 0148-6403 ; 1043-3074
ISSN (online)	1097-0347
ISSN	0148-6403 ; 1043-3074
DOI	10.1002/hed.27457
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Zs.A 1493: Show issues

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Article ; Online: Functional Outcomes and Quality of Life in Patients with Sinonasal, Nasopharyngeal, and Anterior Skull Base Tumors.

Jozaghi, Yelda / Phan, Jack / Hanna, Ehab Y / Kupferman, Michael E / Su, Shirley Y

Current oncology reports

2022 Volume 24, Issue 6, Page(s) 775–781

Abstract: Purpose of review: This article will review functional and QOL outcomes among patients treated predominantly for sinonasal and nasopharyngeal malignancies.: Recent findings: Treatment advances and interdisciplinary supportive care help to lessen the ... ...

Abstract	Purpose of review: This article will review functional and QOL outcomes among patients treated predominantly for sinonasal and nasopharyngeal malignancies. Recent findings: Treatment advances and interdisciplinary supportive care help to lessen the functional impairments and the reduction in quality of life (QOL) that were once accepted as inevitable tradeoffs for cure. Recent progress in QOL and Patient-Reported Outcome (PRO) instruments for this population will be covered. Sinonasal and nasopharyngeal tumors affect patients' quality of life, appearance, and critical functions. Tumors arise in proximity of vital structures including the orbit, cranial nerves, carotid artery, brain, cervical spine, and pituitary gland. Surgical morbidity, along with acute and late effects of systemic therapy and radiotherapy on normal tissues in this functionally critical region, may result in wide-ranging symptoms. Patients with skull base tumors report a high symptom burden at presentation, prior to treatment, relative to other malignancies in the head and neck region.
MeSH term(s)	Endoscopy ; Humans ; Nasopharyngeal Neoplasms/therapy ; Quality of Life ; Skull Base Neoplasms/radiotherapy ; Treatment Outcome
Language	English
Publishing date	2022-03-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057359-5
ISSN	1534-6269 ; 1523-3790
ISSN (online)	1534-6269
ISSN	1523-3790
DOI	10.1007/s11912-022-01214-2
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Zs.A 5521: Show issues

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Article ; Online: Long-term oncological outcomes for endoscopic endonasal versus open surgical approaches for anatomically matched, locally advanced stage T4 sinonasal malignancies with skull base involvement.

Schur, Solon / Hanna, Ehab Y / Su, Shirley Y / Kupferman, Michael E / DeMonte, Franco / Raza, Shaan M

Journal of neurosurgery

2023 Volume 140, Issue 3, Page(s) 688–695

Abstract: Objective: Expanded endoscopic approaches (EEAs) are increasingly used for the definitive management of sinonasal malignancies. EEAs, in appropriately selected cases, provide similar oncological outcomes but are associated with lower complication rates ... ...

Abstract	Objective: Expanded endoscopic approaches (EEAs) are increasingly used for the definitive management of sinonasal malignancies. EEAs, in appropriately selected cases, provide similar oncological outcomes but are associated with lower complication rates compared with open surgical approaches. Selection bias is a limitation reported in previous studies comparing EEAs and open surgical approaches for the management of sinonasal malignancies. To address this issue, in this study the authors compared the long-term oncological outcomes of an anatomically matched cohort of patients with locally advanced sinonasal malignancies with skull base involvement (T4 stage). The specific objective of this study was to investigate the extent of resection (EOR), overall survival (OS), and disease progression between the EEA and open surgical cohorts. Methods: A cohort of 42 patients with locally advanced sinonasal malignancies and skull base involvement (stage T4) and operated on via an EEA was matched anatomically with a cohort of 54 patients who had undergone open surgery. A retrospective chart review was conducted on these 96 patients who were treated between September 1993 and June 2020. All patients in the cohort were eligible for either an EEA or open surgery according to anatomical criteria. Patients of all ages were included, and the minimum follow-up required for eligibility was 4 months. Patients were excluded if surgery was not offered for curative intent and preoperative imaging did not demonstrate that gross-total resection was achievable. Results: There were more complications in the conventional surgery cohort than in the EEA cohort (33.33% vs 14.29%, p = 0.033). There was no significant difference in the EOR between the EEA and conventional surgery cohorts, as demonstrated by comparable rates of positive margins in both groups (5.56% vs 2.38%, respectively). Disease progression (hazard ratio [HR] 0.47, 95% CI 0.17-1.27, p = 0.137) was lower and OS (HR 0.58, 95% CI 0.26-1.29, p = 0.183) was higher in the EEA cohort, but these findings did not reach statistical significance. Conclusions: The EEA was found to be associated with lower risks of complications than conventional craniofacial surgical approaches. There were no significant differences in OS and progression-free survival between the EEA and conventional surgical cohorts when comparing anatomically matched cohorts of patients with stage T4 sinonasal malignancies and skull base involvement.
MeSH term(s)	Humans ; Retrospective Studies ; Head ; Skull Base/surgery ; Endoscopy ; Disease Progression ; Skull Base Neoplasms/surgery ; Treatment Outcome
Language	English
Publishing date	2023-09-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2023.7.JNS23786
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Article ; Online: Orbital and periocular complications in patients with sinonasal tumours with orbital invasion.

Zhao, Jiawei / Jiang, Xinyang / Hanna, Ehab / Su, Shirley Y / Moreno, Amy / Gunn, Brandon / Frank, Steven Jay / Ferrarotto, Renata / Ning, Jing / Esmaeli, Bita

The British journal of ophthalmology

2024 Volume 108, Issue 3, Page(s) 465–470

Abstract: Aims: The purpose of this study was to determine the frequency and associated risk factors of orbital/periocular complications in patients with sinonasal tumour with orbital invasion managed with eye-sparing treatments.: Methods: A retrospective case ...

Abstract	Aims: The purpose of this study was to determine the frequency and associated risk factors of orbital/periocular complications in patients with sinonasal tumour with orbital invasion managed with eye-sparing treatments. Methods: A retrospective case series of patients with primary sinonasal tumour with orbital invasion from January 2008 to December 2018. Patient factors were compared between the following groups: (1)patients with orbital/periocular complications versus those who did not and (2) patients who needed secondary oculoplastic surgical procedures versus those who did not. Results: Out of 80 patients, 48 had eye-sparing surgery, 8 had orbital exenteration and 24 were managed non-surgically. The most common histology was squamous cell carcinoma (n=28, 35%). Among the eye-sparing treatment group, 51/72 patients experienced one or more orbital/periocular complication(s), with motility deficit (N=26, 36%) being the most frequent. Factors associated with higher risk of complications included tumour involving the orbital floor (p=0.019), clinical disease stage III/IV (p=0.038), maxillectomy (p=0.004), resection of the orbital floor (p=0.027) and cigarette smoking (p=0.041). Tumour involving the orbital floor had an OR of 3.9 (95% CI 1.3 to 11.6, p=0.016) in predicting orbital/periocular complication. In the eye-sparing surgery group, the most frequent secondary oculoplastic procedures was dacryocystorhinostomy (n=6, 13%). The use of a free flap in reconstruction had an OR of 8.2 (95% CI 2.1 to 31.8, p=0.002) in predicting need for secondary oculoplastic surgery. Conclusion: Majority of patients with sinonasal tumours and secondary orbital invasion were managed with eye-sparing multidisciplinary treatments. Preservation of the eye can lead to reasonably good functional outcome despite expected orbital and periocular complications.
MeSH term(s)	Humans ; Retrospective Studies ; Orbit/surgery ; Plastic Surgery Procedures ; Orbit Evisceration ; Carcinoma, Squamous Cell/surgery
Language	English
Publishing date	2024-02-21
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	80078-8
ISSN	1468-2079 ; 0007-1161
ISSN (online)	1468-2079
ISSN	0007-1161
DOI	10.1136/bjo-2022-322855
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Article ; Online: Leprosy of the great auricular nerve: case report and review of the literature.

Kaya, Diana / Garnes, Natalie Dailey / Robins, Alison / Su, Shirley Yu / Ginsberg, Lawrence E / Chen, Melissa Mei

Clinical imaging

2021 Volume 82, Page(s) 63–66

Abstract: We report clinical, imaging and pathology findings of a patient with leprosy of the great auricular nerve who presented with palpable nodules and numbness of the left ear and scalp. Ultrasound and contrast-enhanced CT imaging of the neck demonstrated ... ...

Abstract	We report clinical, imaging and pathology findings of a patient with leprosy of the great auricular nerve who presented with palpable nodules and numbness of the left ear and scalp. Ultrasound and contrast-enhanced CT imaging of the neck demonstrated diffuse enlargement and enhancement of the great auricular nerve. Biopsy of the enlarged left great auricular nerve revealed granulomatous inflammation with necrosis involving the nerve with rare Fite-positive organisms compatible with mycobacterium. Positive PCR for Mycobacterium leprae of the surgical specimen confirmed diagnosis of Hansen's disease.
MeSH term(s)	Biopsy ; Humans ; Leprosy ; Mycobacterium leprae ; Ultrasonography
Language	English
Publishing date	2021-10-15
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	1028123-x
ISSN	1873-4499 ; 0899-7071
ISSN (online)	1873-4499
ISSN	0899-7071
DOI	10.1016/j.clinimag.2021.10.001
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Zs.A 1469: Show issues

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Article ; Online: The Role of Sentinel Lymph Node Biopsy in the Management of Cutaneous Malignancies.

Ahmad, Faisal I / Su, Shirley Y / Gross, Neil D

Facial plastic surgery clinics of North America

2018 Volume 27, Issue 1, Page(s) 119–129

Abstract: Sentinel lymph node biopsy uses the concept of selective lymphatic drainage and the lymphatic microvasculature to identify first-echelon nodes draining a given malignancy. Although initially considered difficult and unreliable in the head and neck, ... ...

Abstract	Sentinel lymph node biopsy uses the concept of selective lymphatic drainage and the lymphatic microvasculature to identify first-echelon nodes draining a given malignancy. Although initially considered difficult and unreliable in the head and neck, experience with the technique has improved and evolved significantly over the last 3 decades. It is now recognized to be accurate and reliable for regional nodal staging and detection of occult nodal metastasis in the head and neck. Although initially described for nodal staging of melanoma, the usefulness of sentinel lymph node biopsy continues to expand and is now extended to other cutaneous malignancies.
MeSH term(s)	Head and Neck Neoplasms/pathology ; Head and Neck Neoplasms/surgery ; Humans ; Neoplasm Staging ; Patient Selection ; Predictive Value of Tests ; Sentinel Lymph Node Biopsy ; Skin Neoplasms/pathology ; Skin Neoplasms/surgery
Language	English
Publishing date	2018-11-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1315178-2
ISSN	1558-1926 ; 1064-7406
ISSN (online)	1558-1926
ISSN	1064-7406
DOI	10.1016/j.fsc.2018.08.004
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Se 1408: Show issues

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Article ; Online: Soft Tissue Sarcomas of the Head and Neck Region with Skull Base/Intracranial Invasion: Review of Surgical Outcomes and Multimodal Treatment Strategies: A Retrospective Case Series.

Habib, Ahmed / Edem, Idara / Bell, Diana / Su, Shirley Y / Hanna, Ehab Y / Kupferman, Michael E / DeMonte, Franco / Raza, Shaan M

Current oncology (Toronto, Ont.)

2022 Volume 29, Issue 9, Page(s) 6540–6550

Abstract: Soft tissue sarcomas (STS) invading the skull base are rare with little data to guide surgical management. Here we aimed to determine the factors affecting tumor control rates and survival in patients with T4 stage head and neck STS involving the skull ... ...

Abstract	Soft tissue sarcomas (STS) invading the skull base are rare with little data to guide surgical management. Here we aimed to determine the factors affecting tumor control rates and survival in patients with T4 stage head and neck STS involving the skull base. A retrospective review of STS patients, surgically treated at our institution between 1994 and 2017 was conducted. Variables were collected and assessed against progression-free survival. Tumors were graded using the Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) system. A total of 51 patients (mean age of 35) were included, of whom 17 (33.3%) patients were FNCLCC grade 1, 8 (15. 7%) were FNCLCC grade 2 and 26 (51%) were FNCLCC grade 3. The median PFS was 236.4 months while the 5- and 10-year PFS rates were 44% and 17%, respectively. Recurrence occurred in 17 (33.3%) patients. Local recurrence occurred in 10 (58.8%). Univariate analysis revealed R0 resection had a near-significant impact on tumor control in radiation-naïve patients. Otherwise, prior radiation (HR 6.221, CI 1.236-31.314) and cavernous sinus involvement (HR 14.464, CI 3.326-62.901) were negative predictors of PFS. The most common cause of treatment failure was local recurrence. In T4 stage head and neck STS with skull-base involvement, FNCLCC grade, radiation status, and anatomic spread should be considered in determining the overall treatment strategy.
MeSH term(s)	Adult ; Combined Modality Therapy ; Humans ; Retrospective Studies ; Sarcoma/pathology ; Skull Base/pathology ; Soft Tissue Neoplasms ; Treatment Outcome
Language	English
Publishing date	2022-09-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol29090514
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Zs.A 4305: Show issues

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Article ; Online: Impact of salvage surgery for recurrent sinonasal cancers with skull base and intracranial involvement.

Schur, Solon E / Hanna, Ehab Y / Su, Shirley Y / Kupferman, Michael E / DeMonte, Franco / Raza, Shaan M

Journal of neurosurgery

2022 , Page(s) 1–8

Abstract: Objective: Patients with recurrent sinonasal cancers (RSNCs) often present with extensive involvement of the skull base and exhibit high rates of subsequent recurrence and death after therapy. The impact of salvage surgery and margin status on ... ...

Abstract	Objective: Patients with recurrent sinonasal cancers (RSNCs) often present with extensive involvement of the skull base and exhibit high rates of subsequent recurrence and death after therapy. The impact of salvage surgery and margin status on progression-free survival (PFS) and overall survival (OS) has yet to be demonstrated. The goal of this study was to determine whether skull base resection with negative margins has an impact on outcomes in the recurrent setting. Methods: A retrospective chart review of 47 patients who underwent surgery for RSNC with skull base invasion between November 1993 and June 2020 was conducted. The following variables were extracted from the clinical records: patient demographic characteristics (age and sex), tumor pathology, dural and orbital invasion, and prior radiation exposure and induction chemotherapy. Metastatic disease status, surgical approach, margin status, and history of postoperative chemotherapy and/or postoperative radiation therapy were noted. The primary and secondary outcomes were PFS and OS, respectively. Results: The cohort included 30 males (63.8%) and 17 females (36.2%), with a mean ± SD age of 54.8 ± 14.4 years. Thirty-five (74.5%) patients showed disease progression, and 29 (61.7%) patients died during the study period. The mean ± SD patient follow-up period was 61.8 ± 64.4 months. Dural invasion was associated with increased risk of death (HR 2.62, 95% CI 1.13-6.08). High-risk histopathology (HR 3.14, 95% CI 1.10-8.95) and induction chemotherapy (HR 2.32, 95% CI 1.07-5.06) were associated with increased odds of disease progression. When compared to patients with positive margins or gross-total resection with unknown margin status, those with negative margins had decreased odds of disease progression (HR 0.30, 95% CI 0.14-0.63) and death (HR 0.38, 95% CI 0.17-0.85). Conclusions: RSNCs show high rates of subsequent disease progression and mortality. This study demonstrated that negative margins may be associated with improved PFS and OS in carefully selected patients who have undergone salvage surgery for RSNC.
Language	English
Publishing date	2022-02-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2021.12.JNS212278
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Article ; Online: The impact of expanded endoscopic approaches on oncologic and functional outcomes for clival malignancies:a case series.

Schur, Solon / Passer, Joel Z / Hanna, Ehab Y / Su, Shirley Y / Kupferman, Michael E / DeMonte, Franco / Raza, Shaan M

Journal of neuro-oncology

2022 Volume 159, Issue 3, Page(s) 627–635

Abstract: Introduction: Clival malignancies pose particular surgical challenges due to complex skull base anatomy and the involvement of vital neurovascular structures. While endoscopic endonasal approached are widely used, the outcomes for clival malignancies ... ...

Abstract	Introduction: Clival malignancies pose particular surgical challenges due to complex skull base anatomy and the involvement of vital neurovascular structures. While endoscopic endonasal approached are widely used, the outcomes for clival malignancies remain poorly understood. In this study we assessed the impact of endoscopic and open surgical approaches on PFS, time to initiation of radiotherapy, KPS, and GTR rates for clival malignancies. Methods: A retrospective case series for clival malignancies operated between 1993 and 2019 was conducted. Inclusion criteria were age over 18 and a follow-up of at least a 6 months. Statistical analyses were conducted using STATA version 15 statistical software package StataCorp. Results: For the whole cohort (113 patients), and for upper and middle lesions, open surgical approaches increased odds of disease progression, compared to EEA (HR 2.10 to HR 2.43), p < 0.05. EEA had a shorter time interval from surgery to initiation of radiotherapy. No difference in 6 and 12 month KPS was found between surgical groups. Patients undergoing open surgery were less likely to achieve GTR for upper clival lesions. Conclusions: EEA was found to be associated with increased PFS, for upper and middle clival malignancies. The time to initiation of radiotherapy was shorter for patients undergoing EEA compared to open surgery for patients with middle clival involvement. GTR rates were found to be significantly better with EEA for patients with upper clival malignancies.
MeSH term(s)	Chordoma/surgery ; Cranial Fossa, Posterior/surgery ; Humans ; Infant ; Retrospective Studies ; Skull Base ; Skull Base Neoplasms/surgery
Language	English
Publishing date	2022-08-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	604875-4
ISSN	1573-7373 ; 0167-594X
ISSN (online)	1573-7373
ISSN	0167-594X
DOI	10.1007/s11060-022-04103-7
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