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Paranasal Sinus Cancer

By Bradley A. Schiff, MD

Cancer of the paranasal sinuses occurs mainly in the maxillary and ethmoid sinuses (see Figure: Locating the Sinuses). Although rare in the United States, these cancers are more common in Japan and among the Bantu people of South Africa. Doctors are not sure what causes these cancers, but they are more common among people who regularly inhale certain types of wood and metal dust. Doctors do not think chronic sinusitis causes these cancers.

Because the sinuses provide room for the cancer to grow, most people do not develop symptoms until the cancer is well advanced. Symptoms, including pain, a sensation of nasal obstruction, double vision, nosebleeds, and loosened teeth in the jawbone underneath the affected sinus, result from the pressure of the cancer on nearby structures.

The earlier the cancer is treated, the better the prognosis. However, survival is generally poor. Only about 10 to 20% of people live more than 5 years.

Doctors treat cancer of the sinuses with a combination of surgery and radiation therapy. Recent advances in surgical techniques have allowed doctors to remove the tumors completely, spare uninvolved parts of the face (such as the eye), and reconstruct the area so that the person has a much better appearance.