17. Benign and malignant tumours of the paranasal sinuses

From greek.doctor
  • Diagnosis
    • Histology
    • CT to determine extent
  • Benign
    • Clinical features
      • Nasal airway obstruction
        • Sinusitis
      • Headache
      • Epistaxis
      • Anosmia
    • 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
  • 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)