Olfactory neuroepithelial cells arise in the nasal cavity and quickly spread to the paranasal sinuses, eye socket, bone, and skull base. The main symptoms are stuffy nose, abundant slimy discharge, anosmia, swelling of the malar area. In the diagnosis of aesthetics, the neuroblastoma is based on rhinoscopic data, CT of the paranasal sinuses, MRI of the brain, histological analysis of biopsy material. Treatment depends on the characteristics of the tumor, generally, is a combination of radiological, surgical and chemotherapeutic methods.
Best Exercises/Activities For Olfactory Neuroblastoma
As with most cancers, there is no specific exercise regime or activities available to cure the disease. There is yoga, tai chi, and breathing exercises along with general healthy routines that can be followed to offer systematic relief and help you cope with the situation better. Do not rely on exercise and home remedies for the complete cure of olfactory neuroblastoma. Always go for conventional treatment options and use these therapies as supplementary. Olfactory neuroblastoma can spread aggressively and any delay in treatment can significantly decrease the survival rate and period.
The characteristic symptom of olfactory neuroblastoma is persistent nasal congestion. It is first accompanied by mucous membranes, and then mucopurulent secretions.
Initially, these symptoms can be examined for manifestations of rhinitis, adenoiditis or sinusitis. The alarming moment is the progression of nasal breathing obstruction despite ongoing rhinosinusitis therapy and the development of complete anosmia – loss of smell.
In the early stages, the stuffy nose is one-sided. With the growth of the neuroblastoma, the nasal septum is shifted to the healthy side, which leads to a narrowing of the intact nasal passage and bilateral nasal breathing problem.
The further development of the disease depends on the direction of tumor growth and the location of regional metastasis. With germination in the anterior nasal cavity, neuroblastoma fills it up what can be determined by visual examination of the nasal passages. If tumor growth occurs in the maxillary sinus, then swelling of the zygomatic region on the affected side and swelling of the upper jaw edge can be observed. Germination of the aesthetic neuroblastoma in the oral cavity leads to tooth loss.(3)
Olfactory Neuroblastoma Treatment
Depending on the size and location of the neuroblastoma, the presence and location of metastases, as well as the age and general health of the patient, treatment strategies can be surgical removal of the tumor, radiation therapy or systemic chemotherapy. Generally, it is advisable to combine these methods.
Surgical removal of the olfactory neuroblastoma is particularly effective in the localized nature of the tumor without germination at the base of the brain and metastasis. With a small tumor size, the operation can be performed transnasally with an endoscope.
To transfer the process to the anterior cranial fossa, complex neurosurgical interventions are required. Complete removal of the tumor is not always possible. If olfactory neuroblastoma grows into orbit, then an orbital expiration is performed with the participation of eye surgeons, followed by eye prosthetics.(4)
Olfactory neuroblastoma comes from the olfactory neuron’s epithelium. The olfactory epithelium surrounds the nasal cavity, nasopharynx and ethmoid labyrinth. The neurons in it carry out the selection and transmission of information about the quality and intensity of the smell to the cerebral olfactory centers.
Olfactory neuroblastoma is a rare malignant tumor. It is most often observed in children after the age of 10. Olfactory neuroblastoma makes up about 3% of all tumors of the nasal cavity. As the tumor grows rapidly into the cells of the ethmoid bone and at the base of the skull, it is subject to joint supervision by specialists in the field of ear, nose and throat medicine and neurology.(1)
Pathogenesis And Morphology
The olfactory neuroblastoma is originally located in the upper sections of the nasal cavity. With locally destructive aggressive growth, these neuroblastomas quickly fill the nasal cavity, distributed in the nasopharynx, sinuses, anterior cranial fossa and orbit. Regional metastases occur in the upper cervix, pharynx, submandibular and parotid lymph nodes.
Distant metastases, in general, occur in the lungs, pleura, liver, and bones. It is characteristic that regional and distant metastases are relatively rare in olfactory neuroblastomas in pediatric patients.(2)
- Harvey RJ, Nalavenkata S, Sacks R, et al. Survival outcomes for stage‐matched endoscopic and open resection of olfactory neuroblastoma. Head & neck. 2017;39(12):2425-2432.
- Peckham M, Wiggins R, Orlandi R, Anzai Y, Finke W, Harnsberger H. Intranasal esthesioneuroblastoma: CT patterns aid in preventing routine nasal polypectomy. American Journal of Neuroradiology. 2018;39(2):344-349.
- Attwood JE, Jeyaretna DS, Sheerin F, Shah KA. Mixed Olfactory Neuroblastoma and Adenocarcinoma with In Situ Neuroendocrine Hyperplasia. Head and neck pathology. 2019:1-7.
- Yin Z, Wang Y, Wu Y, et al. Age distribution and age-related outcomes of olfactory neuroblastoma: a population-based analysis. Cancer management and research. 2018;10:1359.
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