Paranasal Research Articles

Paranasal Sinus Visualization Capabilities of a Novel Articulating Rigid-Flexible Endoscope: A Cadaveric Study

Abstract Introduction Rigid endoscopes have allowed surgeons to safely perform endoscopic sinus surgery. However, their rigid nature creates inherent visualization limitations. The study herein looks to assess the visualization potential of a novel articulating rigid-flexible endoscope when compared with traditional rigid and flexible nasal endoscopes. Methods A new articulating endoscope capable of bending its distal tip and extending beyond the point of angulation was compared with 0- and 30-degree 4.0-mm rigid endoscopes, and a 3.7-mm flexible nasopharyngoscope in their ability to visualize predefined anatomic landmarks within the maxillary, sphenoid, and frontal sinuses. Visible markers were placed at applicable landmarks using image guidance in a total of five cadaveric heads. The ability to visualize these intrasinus anatomic landmarks was recorded for each scope. Results When inspecting the surgically naive anatomy of all sinus ostia and predefined anatomic landmarks, the articulating endoscope had superior visualization (p < 0.01) compared with the 0-degree, 30-degree, and flexible endoscopes throughout all sinuses (maxillary sinus: 62.5, 0, 5, and 0%, respectively; sphenoidal sinus: 92.5, 27.5, 37.5, and 40%, respectively; frontal sinus: 51.4, 5.7, 20, and 37.1%, respectively). After performing a Draf IIa, the articulating endoscope was able to visualize 100% of the predefined frontal sinus landmarks compared with 22.9, 45.7, and 65.7% for the 0-degree, 30-degree, and flexible endoscopes, respectively (p < 0.001). Conclusion The articulating rigid-flexible endoscope is superior in reaching and visualizing anatomic landmarks within the paranasal sinuses, compared with standard endoscopes.

Analysing the informative content of the upper jaw pathology visual examination

Objective. To conduct a comparative analysis of the informative content of cone beam computed tomography (CBCT), multispiral computed tomography (MSCT) and paranasal sinuses half-axial X-ray images in the upper jaw pathology diagnosis. Materials and methods. 96 CBCT and MSCT scans of the upper jaw and the similar number of X-ray images of the same patients were analyzed. Results. The analysis of a three-dimensional image and native slice reading in the Planmeca programme makes it possible to determine metric parameters, localization, prevalence of the pathological process and involvement of the upper jaw structures validly. Software features of the Radiant and OneDemand3D had error interval of р ≥ 0,2 mm while analyzing the same criteria. Half-axial X-ray examination demonstrated the lowest informative content. Conclusion. The most informative method of visualization of the upper jaw connective tissue structures, pathological processes, their borders and mutual involvement is CBCT. This is predetermined by the interface functionalities.

Development of maxillary sinuses in relation to the development of cranium in children on computed tomography imaging

There are available studies assessing the development of maxillary sinuses in relation to the viscerocranium. However, there are no publications analyzing the development of maxillary sinuses in relation to the development of the cranium, i.e. both the viscerocranium and the neurocranium. The aim of the study was to analyze the correlation between the dimensions of maxillary sinuses and anthropometric measurements of the cranium in children. The study was retrospective and was conducted at the based on the results of head computed tomography investigation. The study group included 180 girls and 180 boys, aged from birth to 18 years. To assess the correlation between the degree of development of the paranasal sinuses and the growth of the cranium, standard anthropometric points on the skull and strictly defined dimensions of the height, length, width, and volume of right and left maxillary sinuses were used. In the study group, both in girls and boys, a statistically significant positive correlation was found at the significance level of p < 0.0001 between: the height, length, width and volume of right and left maxillary sinuses, and cranial maximum length (glabella-opisthocranion), its maximum width (euryon-euryon), height (basion-bregma) and the length of the cranial base (basion-nasion) and the dimension of the subspinale-opisthocranion in children. Our study showed a statistically significant positive correlation between the development of maxillary sinuses and the growth of the cranium in children.

Sinonasal Tumors: What the Multidisciplinary Cancer Care Board Wants to Know.

Sinonasal neoplasms are a remarkably heterogeneous group, reflecting the numerous tissue types present in the nasal cavity and paranasal sinuses. These entities can be relatively benign (ie, respiratory epithelial adenomatoid hamartoma) or can be exceedingly aggressive (ie, NUT carcinoma). Certain sinonasal tumors have a propensity to spread through local invasion and destruction, while others have a high likelihood of perineural spread. The genetic and molecular mechanisms underlying sinonasal tumor behavior have recently become better understood, and new tumor types have been described using these genetic and molecular data. This has prompted an expansion in the number of tumors included in the World Health Organization fifth edition classification system for head and neck tumors, along with a new classification structure. Radiologists' familiarity with this classification structure is crucial to understanding the expected behavior of these tumors and to collaboration with the multidisciplinary cancer care board in making decisions for optimal patient care. ©RSNA, 2024.

ASPECTS OF ETIOLOGICAL FACTORS OF CYST MAXILLO-FACIAL SINUSES

Upper jaw sinus cysts are a very common disease, often an accidental clinical find upon radiography and computed tomography of the paranasal sinuses. At the same time, there are few reports in the literature about the location of cysts in the frontal and ponal cavities. It is especially difficult to diagnose the cysts of the wedge-shaped cavity, as known radiographic arrangements do not allow them to be diagnosed. The problem of diagnosing paranasal sinus cysts was solved by implementing computed tomography into practice.

Nasal Extranodal NK/T Cell Lymphoma with Orbital Involvement: A Rare Entity of Common Presentations.

Nasal Extranodal NK/T Cell Lymphoma is an aggressive tumour affecting the nasal and midline structures, causing surrounding tissue destruction as the result of its progression. The initial presentations are similar to symptoms of benign nasal polyps, such as nasal obstruction, hyposmia and nasal discharge. As the disease progresses, the involvement of the palate, paranasal sinuses, orbit and skin become alarming symptoms. We report a case of a young male with Nasal ENKTL who presented with symptoms similar to acute on chronic rhinosinusitis with orbital complications. The challenges of diagnosing and getting to the correct management pathway are discussed.

Nasal dermoid cyst

Abstract: Congenital midline lesions of the nose include nasal dermoids, encephaloceles, and gliomas. The nasal dermoid is least rare of these and is an uncommon midline developmental anomaly. Unlike encephalocoeles and gliomas ,craniofacial dermoids may present as a cyst, a sinus or a fistula (Setiyawan, 2013). In this patient, it was a cystic nasal swelling obscuring vision without any problem in visual acuity. He had this lesion from childhood but presented to the outpatient department in adolescent age. Diagnostic nasal endoscopy, ultrasonography, fin- needle aspiration cytology, and contrast-enhanced computed tomography of the nose and paranasal sinuses were done reporting it as a nasal dermoid without any bony erosions. All routine investigations were done, and the patient was planned for excision under general anesthesia (GA). Excision of the mass was done under GA and sent for histopathology. Histopathological examination report confirmed it as a dermoid cyst.

TREATMENT OF MAXILLARY SINUS CYSTS: LITERATURE REVIEW

In recent decades, inflammatory diseases of the nose and paranasal sinuses have firmly taken first place in the overall structure of morbidity of ENT organs, both in the analysis of visits to the clinic and in the group of patients undergoing treatment in inpatient settings. Cysts of the paranasal sinuses are one of the most common diseases in clinical practice.

Wartime penetrating traumatic brain injury of the anterior skull base involving the paranasal sinuses: a single-center, first-year experience from Dnipro, Ukraine.

Since February 2022, the number of casualties in the Russian-Ukrainian war have dramatically increased, with a high incidence of penetrating traumatic brain injuries (pTBIs). To date, there has been limited evaluation of pTBI of the anterior skull base involving the paranasal sinuses. The objective of this study was to highlight the authors' experience with this injury pattern and identify specific factors associated with favorable short-term (1-month) outcome and survival. The authors conducted a single-institution retrospective review of patient data collected from the 1st year of the Russian-Ukrainian war at a frontline civilian Ukrainian hospital. To prevent complications from conservative treatment of pTBI with paranasal sinus injury, a protocol of early primary neurosurgical treatment including debridement/hematoma evacuation, repair of dural defects with vascularized pericranial flaps, and titanium plating of external/skull base defects was implemented. Using 1-month postoperative Glasgow Outcome Scale scores, the authors defined a favorable outcome as good recovery/moderate disability and a poor outcome as severe disability/vegetative state/death. Patient demographics, injury characteristics, imaging findings, and postoperative complications were assessed. Logistic regression models were used to estimate the effect of patient characteristics on unfavorable outcome or survival. From February 2022 to February 2023, there were 141 pTBIs (20%) involving the paranasal sinuses, 134 (95%) due to blast fragmentation. One hundred eighteen patients (84%) had a favorable outcome. Most patients with pTBIs (69%) had other nonbrain-related injuries. While 48 patients (34%) presented with preoperative CSF leak, only 1 patient (0.7%) had persistent postoperative CSF leak, which was managed with lumbar drainage. High admission Glasgow Coma Scale (GCS) score, favorable injury lateralization (single hemisphere involved), and low Injury Severity Score (ISS) were associated with significantly increased odds of favorable short-term outcome, whereas high admission GCS scores and no midline shift were associated with significantly increased odds of survival. This was the largest single-year study on neurosurgical treatment of wartime pTBI involving the paranasal sinuses. Implementation of primary neurosurgical intervention at the time of presentation demonstrated promising early results and a shift away from expectant management of this injury pattern. The association of high admission GCS score, low ISS, favorable injury lateralization, and no midline shift on favorable short-term outcomes or survival has not been previously documented with this injury pattern.

Clinical analysis and literature review of 7 cases of plasmacytoma first diagnosed with head and neck symptoms

Objective:In order to better understand the condition and provide the groundwork for early detection and treatment of plasmacytomas, it is important to examine the clinical characteristics, therapeutic options, and effectiveness of plasmacytomas that are initially identified with head and neck symptoms. Methods:Retrospective analysis, evaluation, and discussion of the clinical data of 7 patients with plasmacytoma initially diagnosed with head and neck symptoms and admitted to the Affiliated Hospital of Qingdao University during the period of June 2013 to November 2022 was done in combination with pertinent literature. Results:All seven patients were diagnosed with plasmacytoma by histopathology, with lesions located in the nasopharyngeal oropharynx in 4 cases, nasal sinuses in 2 cases, and ventricular zone in 1 case. Clinical manifestations and imaging were atypical, with localized manifestations, of which 2 cases were accompanied by multiple skeletal lesions throughout the body, and 4 cases had lymph node metastasis. Surgery was preferred for all patients, and individualized treatment was recommended after surgery. Of the 7 patients, 3 patients underwent surgery and chemotherapy, 2 patients underwent surgery and radiotherapy and chemotherapy, 1 patient underwent surgery and radiotherapy, and 1 case was treated with surgery only. The follow-up period was 3-60 months, with a 100% follow-up rate. 5 cases were alive and 2 cases died of multiple myeloma after 4-5 years Conclusion:Plasmacytomas first diagnosed with head and neck symptoms are rare, and extramedullary plasmacytomas have a better prognosis, while more advanced multiple myeloma has a poorer prognosis; Therefore, enhancing the quality of survival as well as the duration of survival for patients with plasmacytomas requires early diagnosis and individualized treatment.

Variability of the Microbiota in Chronic Rhinosinusitis: A Scoping Review.

Chronic rhinosinusitis (CRS) is characterized by a persistent inflammation of the nasal and paranasal sinus mucosa that could be potentially linked to a dysregulation between the microbiota and the immune system. We aim to explore general, methodological, and microbiological aspects of microbiota research in CRS compared to disease-free individuals. Embase, Ovid MEDLINE, PubMed, Scopus, and Web of Science. All studies comparing the composition of the resident microbiota of the sinonasal cavities in 2 groups: CRS and normal participants. We conducted systematic study selection, data extraction, and analysis first using the title and abstract, and then the full texts based on predefined inclusion and exclusion criteria. Compiled and presented findings include sampling site and technique, and microbiological results such as the relative abundance and the variability of the composition of the microbiota in both groups. Twenty-seven studies, using genomic identification with 16s RNA were analyzed. Case definitions primarily followed EPOS or AAO-HNS guidelines, with endoscopic swabs (82%), and middle meatus sampling (74%) being prevalent techniques. Despite relative abundance variability, patterns emerged across studies, indicating an increase in Haemophilus (19%) and Pseudomonas (11%), and decrease in Propionibacterium (15%) and Anaerococcus (11%). Another pattern was observed, showing a decreased alpha diversity (6/19; 22%) in CRS compared to normal individuals. While variations exist among studies, analysis of CRS microbiota suggests an association with dysbiosis, potentially contributing to chronic inflammation. Future research must prioritize standardized criteria for diagnostics and patient selection, fostering a more comprehensive understanding of CRS microbiota.

Anatomy and function of the canalis sinuosus and its injury prevention and treatment strategies in implant surgery

The canalis sinuosus, a canal containing the anterior superior alveolar nerve bundle, originates from the infraorbital canal and extends along the maxillary sinus and nasal cavity edges to the anterior maxilla. It was once regarded as an anatomical variation. However, with the widespread application of cone beam computed tomography (CBCT), the detection rate of canalis sinuosus in the population has increased. The canalis sinuosus exhibits diverse courses, branching into multiple accessory canals and terminating at the nasal floor or the anterior tooth region, with the majority traversing the palatal side of the central incisor. The anterior superior alveolar nerve bundle within the canalis sinuosus not only innervates and nourishes the maxillary anterior teeth and the corresponding soft tissues, and the maxillary sinus mucosa, but also relates to the nasal septum, lateral nasal wall, and parts of the palatal mucosa. To minimize surgical complications, strategies for preventing and treating canalis sinuosus injuries need to be investigated. Preoperatively, CBCT is used to identify the canalis sinuosus and to virtually design implant placement at a distance of more than 2 mm from the canalis sinuosus. Intraoperatively, assessing bleeding and patient comfort, complemented by precision surgical techniques such as the use of implant surgical guide plates. Postoperatively, CBCT is used to examine the relationship between the implant and the canalis sinuosus, and treatment of canalis sinuosus injuries can be tailored based on the patient's symptoms. This review summarizes the detection of canalis sinuosus in the population, its anatomical characteristics, and the physiological functions in the anterior maxilla, and discusses strategies for avoiding canalis sinuosus injuries during implant surgery, thereby enhancing clinical awareness and providing references for clinical decision-making.

Computed tomography analysis of the infraorbital canal and adjacent anatomical structures.

This study aimed to investigate the incidence of infraorbital canal (IOC) protrusion into the maxillary sinus via computed tomography (CT) and classify its variations. Additionally, it sought to identify nearby sinonasal variations that might elevate the risk of iatrogenic injury. Paranasal sinus CT of 500 patients was evaluated retrospectively. The IOC types were categorized. The length of the IOC, septum, the distance between the maxillary ostium and IOC (dOI), the presence of Haller cells, IOC-related intra-sinus opacity, and IOC dehiscence were investigated. The prevalence of type 3 IOC was 12%, of which 9.2% were type 3c. The maximum length of the IOC was positively correlated with type 3 IOC. A significant difference was found between IOC types in terms of dOI only on the left side. On both sides, the incidence of Haller cells was greater in patients with type 2 IOC than in those with type 1 and in patients with type 3 IOC than in those with type 2. IOC-related opacity and IOC dehiscence were more common in types 2 and 3 IOCs. The assessment of preoperative IOC types and neighboring anatomical structures by CT imaging is of great significance in preventing iatrogenic damage.

A Case Report of Korean Medicine Treatment for Chronic Obstructive Pulmonary Disease Patient with Dyspepsia and Anorexia after Surgery for Colon Cancer and Chemotherapy

Objectives: The purpose of this case study was to report the therapeutic effect of Korean medicine treatment for chronic obstructive pulmonary disease (COPD) patient with dyspepsia and anorexia after surgery for colon cancer and chemotherapy.Methods: A patient with COPD was hospitalized to treat dyspnea, dyspepsia, and anorexia that occurred after surgery for colon cancer and chemotherapy during 22 days. The patient was treated with herbal medicine (Yangjin-tang), acupuncture, pharmaco-puncture, herbal steam therapy, moxibustion, and pulmonary rehabilitation. The effectiveness of the treatment was assessed with modified Medical Research Council (mMRC) scale, Numeric Rating Scale (NRS) for dyspnea and dyspepsia, walking distance, weight, peak expiratory flow (PEF), radiography, pulmonary function test, and laboratory test.Results: The Korean medicine treatment improved mMRC from Grade 4 to Grade 3, NRS of both dyspnea and dyspepsia, walking distance, and maxillary sinusitis on paranasal sinus X-ray. However, there were no changes in weight, PEF, and chest X-ray.Conclusion: The Korean medicine treatment was effective in improving the symptoms of the COPD patient, including dyspnea, dyspepsia, and anorexia. This study suggests that Korean medicine treatment can have therapeutic effect on comorbidities such as dyspepsia and anorexia.

A CASE REPORT OF RECURRENT FRONTAL MUCOCOELE

Background: Paranasal sinus mucocele is the epithelium lined mucus filled sac causing enlargement of sinus wall. It can cause bone erosion and displacement of surrounding structures. Mucoceles usually occur due to infection, inflammation, trauma, previous surgeries, and tumours which can potentially obstruct the sinus ostium. Cranio facial trauma is the commonest cause for mucocele formation. Case report: A 50yr old male patient came with chief complaints of swelling on forehead since 1yr. The patient had history of road traffic accident 13yrs ago for which he underwent facio-maxillary reconstruction along with right eye evisceration. Later he developed a swelling above right eye after 7yrs, which was diagnosed as mucocele and was treated by frontal cranioplasty. Now he came with complaint of swelling on forehead which was gradually increasing in size. MRI-PNS was done showing fluid filled space extending anteriorly from cutaneous plane in the frontal region going posteriorly over the orbit pushing the contents of the orbit inferiorly and medially and extending posteriorly up to orbital apex. Patient underwent endoscopic mucocele drainage and DRAF 3. Right orbital exenteration was done to prevent recurrence. Patient was on follow up since then and no symptoms or signs of recurrence is noted. Conclusion: Facial trauma may be one of the reasons for development of mucocele where sinus drainage pathways are deranged. As in our case trauma not only led to development of mucocele, but new spaces also created by the treatment lead to extensive spread of the mucocele.

Sustained co-release of ciprofloxacin and dexamethasone in rabbit maxillary sinus using polyvinyl alcohol-based hydrogel microparticle

Topical delivery to paranasal sinuses through sustained-release stents is one of the new horizons in treating chronic rhinosinusitis (CRS). This study aims to introduce and evaluate sustained co-release of encapsulated ciprofloxacin (CIP) and dexamethasone (DEX) in polyvinyl alcohol-based carriers within the maxillary sinus of rabbit animals. DEX and CIP were loaded in a tyramine-substituted polyvinyl alcohol microparticle (PVATyr MP). The mechanical stability, degradability, and sustained-release patterns of both drugs as well as cellular cytocompatibility were assessed in vitro. The PVATyr MPs were then injected into the maxillary sinus of rabbits and they were monitored weekly for 21 days. Nasal endoscopy, MRI imaging, and tissue microscopy were used to follow the changes and compared them with the control condition. Also, the concentrations of drugs were evaluated in the maxillary sinus and blood samples over the study period. Produced PVA-based MPs possessed a relatively narrow particle size distribution (CV 7.7%) with proper physical stability until 30 days of incubation. The uniform-sized PVATyr MPs and their surrounding hydrogel showed sustained-release profiles for DEX and CIP for up to 32 days in vitro. The injected drugs-loaded hydrogel showed complete clearance from the maxillary sinus of rabbits within 28 days. The concentrations of DEX and CIP in mucosal remained within the therapeutic window when measured on days 7, 14, and 21, which were well above the plasma concentrations without any pathological changes in endoscopy, MRI imaging, and histological examinations. DEX/CIP loaded PVATyr MPs provided an effective, controlled, and safe sustained-drug delivery in both in vitro and in vivo analyses at therapeutic concentrations with minimal systemic absorption, suggesting a promising treatment approach for CRS.Graphical

Computed Tomography Analysis of the Nasal Septal Deviation and Related Paranasal Sinus Pathologies

Purpose: Nasal Septum Deviation (NSD), which is defined as a dislocated septum, is a prevalent condition that is mostly asymptomatic; however, it can cause difficulties such as nasal obstruction and rhinosinusitis symptoms. Other Paranasal Sinuses (PNS) disorders, e.g., Osteo Meatal Complex (OMC) obstruction, have been assumed to be correlated with NSD. This study investigates the possible correlation of specific radiological findings of PNS pathologies in patients with or without the existence and direction of NSD. We also discussed the different types of NSD and their incidence among different groups stored by age, gender, etc. Materials and Methods: This is a cross-sectional study conducted at multiple imaging centers in Iran between July 2019 and February 2020 to estimate the prevalence of deviated nasal septum and correlate between NSD and other findings using paranasal sinus scans. All the individuals who met the inclusion and exclusion criteria were included in the study. NSD types have been classified based on Mladina's method. Results: We prospectively reviewed PNS Computed Tomography (CT) scans obtained from 254 cases (82 men and 172 women), aged 18 to 81 years (mean: 35.53), evaluated over seven months. Out of 254 cases, 135 (53 %) patients had NSD, without any direction predominance (right-sided vs. left-sided), and equally distributed between genders. The most common NSD types were type V with a frequency of 42.22% and type III with a frequency of 24.44%. Other PNS CT findings were also investigated in our patients, like OMC obstruction, pansinusitis, mucocele, air-fluid level, mucosal thickening, and concha bullosa. There was no statistically significant correlation between any of these pathologies and NSD (P-value &gt; 0.05). Conclusion: Although NSD was observed in more than half of our cases' PNS CTs, there was no significant correlation between NSD and other findings in most subjects. This reveals that the effectiveness of septal repair surgeries in relieving patients' symptoms might not be as high as expected.

Cemento-ossifying fibroma: an extensive fibro-osseous lesion involving paranasal sinuses

Cemento-ossifying fibroma (COF) is a fibro-osseous lesion arising from cells of the periodontal ligament. This tumor typically occurs in individuals during their third and fourth decades of life, with a predilection for women. COF primarily affects the maxillofacial region, most commonly the mandible. Its localization in the paranasal sinuses and skull base is unusual. However, we present a rare case of COF involving the right paranasal areas of the maxillofacial region in an 18-year-old female. Computed tomography (CT) revealed an expansile lesion measuring 52.45×32×74.29 mm involving the right maxillary sinus, expanding into both the anterior and posterior choanae. The patient underwent endoscopic sinus surgery (ESS) with preservation of adjoining vascular structures. Clinical, radiographic, and histologic features are presented, and differential diagnosis is discussed.

The impact of mitomycin C in endoscopic sinus surgeries: a comprehensive review

Chronic rhinosinusitis (CRS) is an inflammation of the nasal and paranasal sinus linings, often resulting in various debilitating symptoms. Functional endoscopic sinus surgery (FESS) is a common treatment for CRS, aiming to alleviate symptoms by restoring sinus drainage and mucosal repair. However, postoperative complications, including adhesion formation, remain a concern. This systematic review aims to evaluate the effectiveness of mitomycin-C (MMC) in reducing postoperative complications, particularly adhesion formation, in patients undergoing ESS. A systematic review of available evidence on the role of MMC in FESS was conducted. Studies were selected based on predefined inclusion criteria, and relevant data were extracted and synthesized. Nineteen studies met the inclusion criteria, encompassing a total of 763 subjects. The majority of studies reported a reduction in postoperative adhesion formation with MMC use, although statistical significance varied. MMC dosages and application methods varied across studies, contributing to heterogeneity in outcomes. Overall, MMC showed promise in reducing adhesion formation and improving surgical outcomes in FESS. However, further high-quality, prospective, randomized controlled trials are warranted to establish optimal dosage, application methods, and long-term efficacy of MMC in FESS for CRS.

Factors affecting the effectiveness of conservative treatment of locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinuses

Background. Currently, the main method of treatment of locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinuses is surgical treatment with subsequent radiation/chemoradiation therapy. However, the survival rate of patients has not changed significantly in the last 20 years. Head and neck squamous cell carcinoma is highly sensitive to chemotherapy and radiation which allows to perform treatment even in cases of locally advanced squamous cell carcinomas of the nasal cavity and paranasal sinuses. However, the question of prognostic factors of the effect of chemoradiation therapy remains open. Therefore, determination of these factors is an important problem. Aim. To evaluate the effectiveness of conservative treatment of locally advanced squamous cell carcinoma of the nasal cavity and paranasalsinuses. Materials and methods. The retrospective analysis included 55 patients with squamous cell carcinoma of the nasal cavity and paranasal sinuses (stages III–IVA) who were under observation and receiving treatment at the N.N. Blokhin National Medical Research Center of Oncology between 2000 and 2020. In 50 (90.9 %) patients, treatment began with induction chemotherapy with subsequent radiation therapy per the radical program. In this patient group, treatment effectiveness was evaluated per the RECIST 1.1 (Response Evaluation Criteria In Solid Tumors) criteria. Results. Five-year overall and progression free survival rates were 49.5 and 22.5 %, respectively. Objective response rate after treatment was achieved in 65.5 % of cases: complete response was observed in 38.2 % of cases (n = 21); partial response in 27.3 % (n = 15); stable disease in 18.2 % of cases (n = 10); disease progression in 16.4 % (n = 9). Conclusion. According to the results of the study, conservative treatment is a promising approach in locally advanced squamous cell carcinoma of the nasal cavity and paranasal sinuses. Patients with complete response to treatment have the highest odds of cure and improved long-term outcomes.