Tumors of the Nose and Paranasal Sinuses

Abstract

Tumors of the nose and paranasal sinuses are rare. Nasal and paranasal sinus tumors encompass a wide variety of both benign and malignant pathologies. Most sinonasal malignancies arise from the maxillary sinus. The most common symptoms of nasal cavity tumors include obstruction of airflow through the nose, nasal discharge, pain, and epistaxis. Sphenoid sinus neoplasms that involve the cavernous sinuses laterally can cause defects of the third, fourth, and sixth cranial nerves. Paranasal sinus tumors manifest insidiously, often hidden within the sinus recesses and mimicking sinusitis or headaches until involvement of adjacent structures such as the eye, nasolacrimal duct, pterygopalatine fossa, palate, and optic chiasm lead to symptoms such as visual changes, epiphora, loss of sensation, loosening of teeth, and double vision. Imaging of paranasal sinus tumors is important in their evaluation. A wide variety of surgical approaches, both open and endoscopic, exist for resection of nasal and paranasal tumors. Challenges lie in the diagnosis and treatment of these tumors as the confined spaces of the nasal vault and paranasal sinuses necessarily force these tumors in close proximity to the orbit, the cavernous sinuses, the base of the skull, the hard palate and dentition, and the soft tissues of the nose and face. The relative rarity of these tumors makes definitive treatment recommendations difficult.