17. Benign and malignant tumours of the paranasal sinuses
- Diagnosis
- Histology
- CT to determine extent
- Benign
- Clinical features
- Nasal airway obstruction
- Sinusitis
- Headache
- Epistaxis
- Anosmia
- Nasal airway obstruction
- Inverted papilloma
- Epithelial tumor
- Endophytic growth
- Locally aggressive
- Can transform into SCC
- Surgical removal
- Fungiform papilloma
- Exophytic growth
- Osteoma
- Asymptomatic until they obstruct drainage of paranasal sinuses
- Surgical removal when it becomes symptomatic
- Clinical features
- Malignant
- More common than benign
- 80% are epithelial
- 20% adenocarcinoma, lymphoma, melanoma, sarcoma
- Nasal cavity > maxillary sinus > ethmoid cells
- Older adults
- Clinical features
- Nasal airway obstruction
- Bloody rhinorrhoea
- Nasal odour
- Refractory unilateral sinusitis
- Advanced
- Swelling
- Pain
- Numbness of cheek
- Orbital infiltration
- Diagnosis
- Endoscopy
- Search for lymph node metastases
- CT/MRi
- Treatment
- Surgery and postoperative radiation
- Facial reconstruction
- Neck dissection if metastases (only 20% of cases)