Paranasal Sinus and Nasal Cavity Cancer

Note: The information on cancer types on the ACRF website is not designed to provide medical or professional advice and is for information only. If you have any health problems or questions please consult your doctor.

  • What is Paranasal Sinus and Nasal Cavity Cancer?

    Paranasal Sinus and Nasal Cavity Cancer is a Head and Neck Cancer which occurs when the cells that form mucus within our nose and uppermost respiratory system turn cancerous.

    ‘Paranasal’ refers to an area around or near the nose, and there are several paranasal sinuses – the frontal sinus, the maxillary sinus, the ethmoid sinus, and the sphenoid sinus. Each of these hollow, air-filled structures are named according to the facial bones which surround them.

    The most common type of Paranasal Sinus and Nasal Cavity Cancer is squamous cell carcinoma, which forms in the thin, flat cells that line the insides of the sinuses and nasal cavity.

    Melanomas and sarcomas may also occur in these facial regions.

  • Paranasal Sinus and Nasal Cavity Cancer Symptoms

    It’s important to note that a number of conditions may cause these symptoms. Please consult your GP for a thorough examination.

    • Blocked sinuses, or sinus pressure, that doesn’t clear
    • Pain in the sinus areas
    • Nosebleeds
    • A lump or sore inside the nose, on the face, or on the roof of the mouth, that does not heal
    • Numbness or tingling in the face
    • Onset of swelling in the eyes, troubled vision, or outward-turning eyes
    • Pain or pressure in the ear.
  • Paranasal Sinus and Nasal Cavity Cancer Treatment

    Treatment for Paranasal Sinus and Nasal Cavity Cancer will depend on the severity of the cancer, the exact location, and the level of the patient’s health.

    For the majority of patients, surgery will be advised to remove the cancer and radiotherapy will usually follow to eliminate any remaining cancer cells.

    The area in which these cancers reside is quite sensitive, with many important nerves, blood vessels, and of course the eye, brain and carotid arteries which supply blood to the brain. Surgery needs to be planned very carefully, maintaining maximum function and appearance of these vital organs and structures. The extent of the surgery and any reconstruction options should be discussed with the treating doctor.

    For cancers in the nasal cavity, a procedure called ‘wide local excision’ will be used to remove the tumour. An area of normal tissue around it will also be removed to ensure traces of the cancer are eliminated. Depending on whether the tumour is in the middle dividing wall of the nasal cavity (known as the nasal septum), or one of the lateral sides of the nose, surgeons will approach the cancer in different ways. Sometimes, the surgeon can reach the tumour by cutting into the upper lip as well.

    If the cancer has reached the external skin of the nose, all, or part of the nose may need to be removed, and reconstructive surgery or a cosmetic prosthesis may be available to build a new nose.

    Paranasal sinus cancers are more difficult to access. Depending on the size and location (which sinus areas are affected), the following operations may be used:

    • External ethmoidectomy: cutting through the skin on the upper side of the nose next to the upper eyelid to remove bone on the inner side of the eye socket and access the ethmoid sinuses.
    • Maxillectomy: an incision is either made under the upper lip (as discussed above) or along the side of the nose from the eyebrow and down to the upper lip. The bones around the maxillary sinus are cut to remove the entire tumour and surrounding tissue in one piece. The bone from the roof of the mouth, upper teeth, part of the cheekbone, and part of the eye socket may be affected.
    • Craniofacial resection: similar to a maxillectomy, but with the potential removal of upper parts of the eye socket and the front of the skill base.

    Where possible, if the tumours are small, these extensive surgery options will be replaced by endoscopic surgery, which uses a small, flexible lighted tube to navigate through the nose, reach the cancer location, and remove the tumour. Through this technology, the surgeon doesn’t have to cut through any bone, and recovery time is usually faster. Please note this is a highly specialised procedure and should be conducted by surgeons with extensive training.

    If the cancer has spread as far as the lymph nodes in the neck, these lymph nodes might also need to be removed.

    Radiotherapy and chemotherapy will be used either before surgery (to minimise the size of the tumour) or afterwards (to ensure as much of the cancer as possible is eliminated). Chemotherapy for nasal cavity and paranasal sinus cancers will likely include a combination of several anti-cancer drugs.

  • Paranasal Sinus and Nasal Cavity Cancer Risk

    Due to the function of these body parts, exposure to dangerous chemicals, dust or smoke is a key risk factor for paranasal sinus and nasal cavity cancer. In addition, the Human Papillomavirus has been linked with this type of head and neck cancer.

Cancer Statistics

  • 1 in 3

    men will be diagnosed with cancer before the age of 75

  • Cancer

    is the leading cause of death of children by disease

  • 1 in 4

    women will be diagnosed with cancer before the age of 75

Together we can change the statistics and
outsmart cancer for good

REFERENCES

Cancer in Australia 2017, Australian Institute of Health and Welfare

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