Paranasal sinus tumours (鼻竇腫瘤)

Pathology:

• Benign tumours – include papillomas, adenomas, osteomas and angiomas. The inverting papilloma may undergo malignant change.
• Malignant tumours – 50% of malignant tumours are found in the maxillary sinus. Squamous cell carcinoma is the most common type. Others include adenocarcinoma, adenoid cystic carcinoma, melanoma and sarcoma.

Clinical features:

Benign tumours frequently present as a unilateral nasal polyp. Malignant tumours spread medically to produce nasal obstruction or epistaxis, posteriorly to give Eustachian tube obstruction and cranial nerve palsies, inferiorly to disrupt the teeth to give proptosis or epiphora. Lateral spread produces swelling of the cheek.

Management:

Prior to treatment planning, histological diagnosis and radiological assessment of the extent of the tumour using CT scanning and sinus tomography are necessary. Benign tumours are treated by local extension, either endoscopically or by an external lateral rhinotomy approach. 

Malignant tumours have a poor prognosis due to their late presentation and extensive spread. When curative treatment is possible a combination of radical surgery (maxillectomy) and radiotherapy is usually used. The resulting defect is filled with a dental plate and obturator.