Olfactory Neuroblastoma / Esthesioneuroblastoma

The Skull Base Surgery Center, led by ENT/Head and Neck Surgery Chairman Eric Genden, MD, and Neurosurgery Chairman, Joshua B. Bederson, MD, specializes in the treatment of olfactory neuroblastomas, also commonly called esthesioneuroblastoma. Olfactory neuroblastoma is a rare form of cancer that involves the nasal cavity. Since its first description in 1924, there have been about 1,000 reported cases. As a major referral center in the tri-state area, the Mount Sinai’s fellowship-trained skull base surgeons have great experience in treating this rare condition. It could be diagnosed at any age but is noted to have bimodal peak of occurrence in the third and sixth decades.

Olfactory Neuroblastoma Symptoms

Symptoms of olfactory neuroblastoma include the following:

  • nasal obstruction and epistaxis
  • anosmia
  • headache
  • nausea
  • facial swelling or pain
  • ocular proptosis or decrease in vision with decreased movement of extraocular muscles

Olfactory Neuroblastoma Diagnosis and Treatment

It is very important to undergo early biopsy of a discovered nasal mass on CT or MRI to establish early diagnosis. When diagnosed, several treatment plans exist tailored to the specific needs of each patient. Whenever possible, complete surgical resection coupled with postoperative radiation therapy is recommended. In more recent years, postoperative chemotherapy regimens have also been used.

With regard to surgical therapy, the size and location of the tumor will help guide whether an open craniofacial procedure or a more minimally invasive endoscopic procedure where the surgery is performed through the nose can be employed. Prognosis depends on the histology obtained at time of surgery.

Olfactory Neuroblastoma Recovery and Care

Depending on the size of the tumor and extent of surgery, patients are usually discharged from the hospital after 3-7 days with the first 1-2 nights spent in the Neurocritical Care Unit. There are no dietary restrictions and physical activity with our physical therapists is encouraged on the first postoperative day. In some instances, a lumbar drain is used to help decompress cerebrospinal fluid to assist in healing.

Care must be used to avoid nose blowing; patients should expect to have nasal packs in place for approximately a week. Once discharged, the first postoperative visit is within one week of surgery to help plan the adjuvant therapy with the assistance of the oncologist. Recent studies have shown that if diagnosed early, there is an approximately 70 percent five-year survival rate.