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Trans-Frontal Five-Fluorouracil (TraFFF): a novel technique for the application of adjuvant topical chemotherapeutic agents in sinonasal adenocarcinoma
  1. Narinder Singh,
  2. Eugene Wong,
  3. Johnson Huang,
  4. Faruque Riffat
  1. Otolaryngology, Head and Neck Surgery, Westmead Hospital, Sydney, NSW, Australia
  1. Correspondence to Dr Eugene Wong, eugene.hl.wong{at}


Sinonasal adenocarcinoma has traditionally been treated with surgery (craniofacial or endoscopic) and adjuvant radiotherapy. Two large series have demonstrated favourable 5-year survival using surgery with adjuvant topical chemotherapy applied repeatedly over several weeks. The authors describe a novel, transnasal application of topical 5-fluorouracil. However, complete coverage of the frontal region of the anterior skull base can be difficult to achieve with a purely transnasal approach in an outpatient setting. We present a novel adjunct method of delivering chemotherapeutic agents into this key area used in a 37-year-old man with T2N0M0 ethmoid adenocarcinoma. The procedure was well tolerated in an outpatient setting and remains disease free at 3 years postoperatively. We suggest that frontal trephination is a useful adjunct to aid accurate placement of adjuvant topical chemotherapeutic agents in the treatment of sinonasal adenocarcinoma.

  • ear, nose and throat/otolaryngology
  • cancer intervention

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  • Contributors All authors (NPS, EW, JH, FR) were involved in study conception and design, acquisition of data, drafting of the manuscript and critical review, and final approval of the manuscript. All authors (NPS, EW, JH, FR) agree to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.