Abstract

BACKGROUND AND OBJECTIVES
To determine the rate and the risk factors for sinonasal-cutaneous fistula formation after treatment for sinonasal malignancy.
METHODS
Between 1991 and 2002, 99 patients with advanced sinonasal malignancy received radiation therapy +/- surgery. Primary site was maxillary sinus in 30, ethmoid sinus in 19, nasal cavity in 32, nasopharynx in 3, and sphenoid sinus in 15 patients. Eighty-two percent of patients had T4 disease. Sixty-eight percent of patients had undergone surgical resection. Median follow-up was 70.6 months.
RESULTS
Eight patients developed ≥ grade 3 sinonasal-cutaneous fistulas at a median time of 3.8 months after radiation. The overall rates of developing ≥ grade 3 fistulas in the entire group at 2 and 5 years were 6% and 10%, respectively. The fistulas were in the medial canthus in seven patients and in the infraorbital region in one patient. Fistulas developed exclusively along the transfacial incision scar and in patients whose tumors extended to the subcutaneous tissues. In univariate analysis, squamous cell carcinoma histology (P ¼ 0.008), ≤ T4a primary tumor category (P ¼ 0.02), and transfacial incision (P ¼ 0.02) were associated with increased risk of fistula formation.
CONCLUSIONS
Histologic subtype, T category, and quality of the skin and the underlying supporting tissues after transfacial incision are risk factors for sinonasal-cutaneous fistula formation.

Links

Aggregator Full Text

Authors

Cianchetti M, Varvares MA, Deschler DG, Liebsch NJ, Wang JJ, Chan AW

Institution

Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.

Source

Journal of surgical oncology 105:3 2012 Mar pg 261-5

MeSH

Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols
Carcinoma
Chemotherapy, Adjuvant
Cisplatin
Cutaneous Fistula
Etoposide
Female
Fistula
Follow-Up Studies
Humans
Male
Middle Aged
Nasal Cavity
Neuroectodermal Tumors
Paranasal Sinus Diseases
Paranasal Sinus Neoplasms
Paranasal Sinuses
Postoperative Complications
Radiotherapy
Radiotherapy, Adjuvant
Retrospective Studies
Risk Factors
Sarcoma
Young Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22375288