(See also Overview of Head and Neck Tumors Overview of Head and Neck Tumors Head and neck cancer develops in almost 65,000 people in the United States each year. Excluding skin and thyroid cancers, > 90% of head and neck cancers are squamous cell (epidermoid) carcinomas... read more .)
Although rare in the US, paranasal sinus cancer is more common in Japan and among the Bantu people of South Africa. Men over 40 years are affected most often.
The cause is uncertain, but chronic sinusitis Sinusitis Sinusitis is inflammation of the paranasal sinuses due to viral, bacterial, or fungal infections or allergic reactions. Symptoms include nasal obstruction and congestion, purulent rhinorrhea... read more 
is not believed to be a cause. Human papillomavirus Human Papillomavirus (HPV) Infection Human papillomavirus (HPV) infects epithelial cells. Most of the > 100 subtypes infect cutaneous epithelium and cause skin warts; some types infect mucosal epithelium and cause anogenital warts... read more 
(HPV) and Epstein-Barr virus Overview of Herpesvirus Infections Eight types of herpesviruses infect humans ( see Table: Herpesviruses That Infect Humans). After initial infection, all herpesviruses remain latent within specific host cells and may subsequently... read more (EBV) may play a role in some cases. Risk factors include
Regular inhalation of certain types of wood, leather, and metal dust
Smoking tobacco
Symptoms and Signs of Paranasal Sinus Cancer
Because the sinuses provide room for the cancer to grow, symptoms usually do not develop until the cancer is well advanced. The following symptoms result from local pressure of the cancer on adjacent structures:
Pain
Nasal obstruction and discharge
Epistaxis
Diplopia
Ear pain or fullness
Facial paresthesias
Loose maxillary teeth below the affected sinus
Tumor is sometimes visible in the oral or nasal cavities.
Diagnosis of Paranasal Sinus Cancer
Endoscopy, with biopsy
CT and MRI
Endoscopy, CT, and MRI are most often used to locate and help stage the tumor. Biopsy confirms the cell type. Staging, which includes assessing tumor spread to the brain, face, neck, lungs, and lymph nodes, helps determine treatment.
Prognosis for Paranasal Sinus Cancer
The earlier paranasal sinus cancer is treated, the better the prognosis. Prognosis also depends on histology. Survival is improving but remains generally poor. Overall, about 40% of people will have recurrent disease, and 5-year survival is about 60%.
Treatment of Paranasal Sinus Cancer
Surgery
Often radiation
Sometimes chemotherapy
Treatment for most early-stage paranasal sinus cancers is complete surgical excision. Recent advances in surgical techniques, particularly endoscopic techniques, can sometimes achieve complete tumor excisions, spare surrounding tissues, and achieve reconstruction.
If risk of recurrence is high, radiation therapy is given postoperatively. If surgical excision is not realistic or would cause excessive morbidity, radiotherapy plus chemotherapy may be used.
In some cases, chemotherapy is given to shrink the tumor; if the tumor responds well to the chemotherapy, it is resected surgically. If not, the tumor can be treated with radiation.
More Information
The following English-language resource may be useful. Please note that THE MANUAL is not responsible for the content of this resource.
National Cancer Institute’s Summary: Paranasal Sinus and Nasal Cavity Cancer Treatment
