Merck Manual

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Paranasal Sinus Cancer


Bradley A. Schiff

, MD, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine

Last full review/revision Feb 2020| Content last modified Feb 2020
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Paranasal sinus cancer is cancer originating in the paranasal sinuses, usually in the maxillary and ethmoid sinuses.

Although rare in the United States, paranasal sinus 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 smoke tobacco or regularly inhale certain types of wood and metal dust. Human papillomavirus (HPV) and Epstein-Barr virus (EBV) may sometimes play a role. Doctors do not think chronic sinusitis causes these cancers.

Locating the Sinuses

Locating the Sinuses


Symptoms of paranasal sinus cancer result from the cancer pressing on nearby structures and include

  • Pain

  • A sensation of nasal obstruction

  • Double vision

  • Nosebleeds

  • Ear pain or fullness

  • Facial numbness or tingling

  • Loosened upper teeth underneath the affected sinus

Most people do not develop symptoms until the cancer is well advanced, because the sinuses provide room for an early cancer to grow without pressing on nearby structures.


  • Imaging studies

  • Biopsy

Doctors do imaging studies (typically computed tomography and magnetic resonance imaging) to locate the tumor and describe its extent. To confirm the cancer, a doctor will do a biopsy by removing some tissue and examining it under a microscope. Doctors use a flexible viewing tube called an endoscope to see, biopsy, and sometimes remove a tumor.


The earlier paranasal sinus cancer is treated, the better the prognosis. However, survival is generally poor. Overall, about 60% of people with paranasal sinus cancer live more than 5 years.


  • Surgery

  • Radiation therapy

  • Chemotherapy

Doctors treat paranasal sinus cancer with a combination of surgery and radiation therapy. Recent advances in surgical techniques have allowed doctors to remove some tumors completely through the nose using an endoscope. This can spare uninvolved parts of the face (such as the eye), resulting in better appearance and function after surgery. Radiation therapy is given following surgery if the tumor is likely to recur. Doctors may use radiation or chemotherapy as initial treatment when surgery would be ineffective or too difficult for certain tumors.

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