Malignancies of the Paranasal Sinuses and Skull Base

Abstract

Sinonasal malignancies include a diverse group of uncommon tumors and present challenges in both diagnosis and management. Sinonasal malignancies include a wide variety of histopathologic diagnoses. The most common sinonasal malignancy is squamous cell carcinoma (SCC). Sinonasal cancer presents a therapeutic challenge because of the close proximity of vital structures. Surgical approaches to the skull base can be broken into three categories: open craniofacial approaches, endonasal endoscopic approaches, and endoscopic-assisted approaches, which combines an endoscopic transnasal approach with a craniotomy. The traditional role of chemotherapy in sinonasal cancer was for palliative care in advanced unresectable disease. Endoscopic approaches have revolutionized the treatment of sinonasal cancers, and in appropriate selected patients they result in decreased surgical morbidity without compromising oncologic outcomes. Nonsurgical management approaches, such as chemotherapeutic regimens, are continuing to be developed. Therapeutic management remains a challenging and continuously evolving area.