Neoplasms of the Nose and Paranasal Sinuses

Neoplasms of the Nose and Paranasal Sinuses


Epidemiology:
? 3% of aerodigestive malignancies
? 1% of all malignancies
? males: females 2:1
? Sixth to seventh decades
? Symptomatology difficult
? Nasal cavity (benign = malignant)
? Sinuses (malignant)
o mostly SCCA
o Maxillary most common
o
Location
- Maxillary sinus 70%
- Ethmoid sinus 20%
- Sphenoid 3%
- Frontal 1%


Risk factors
? Occupational exposure in >40% of cases.
• nickel workers – SCCA
• hardwood dust & leather tanning - adenocarcinoma
? Viral - HPV
? Cigarettes & alcohol: little association.


Presentation
- Similar symptoms to common nasal problems.
- Usually with 6 to 8 month delay in diagnosis.
- Cranial neuropathies & proptosis may be the first presentation.

? Oral - 30%
? tooth pain, trismus, palatal fullness, erosion
? Nasal - 50%
? obstruction, epistaxis, discharge, erosion
? Ocular - 25%
? diplopia, proptosis, tearing, pain, fullness
? Facial
? V2 numbness, asymmetry, pain
? Auditory – CHL (conductive hearing loss).