These cancers are often diagnosed late because they may have no symptoms in early stages or symptoms may resemble chronic sinusitis. They can easily spread throughout the sinus area, and cure rates are generally less than 50 percent. Local growth into vital areas is a more common cause of death than metastases.
There are six sinuses, two just below the eyes (maxillary), two above the eyes (frontal) and two in the center, behind the nose (ethmoid and spheroid). The maxillary sinus is the one most commonly involved, and cancer there can be difficult to diagnose. It may be necessary to expose the maxillary sinus through a small opening in the mouth above the canine teeth in the upper jaw (Caldwell-Luc procedure).
Treatment Overview Treatment of these tumors is very complex and requires very precise pretreatment evaluation and planning. Most patients require a combination of radiotherapy and surgery.
• Since lymph nodes are involved in only about 20 percent of cases, surgery or radiotherapy to the lymph nodes
in the neck is used only if these nodes contain tumor.
• For patients who have tumors that can be removed at surgery, the surgery may be followed by radiotherapy. In
some centers, all Stage II and III tumors are treated with radiotherapy before surgery.
• Sometimes it is necessary to surgically explore the area of the tumor to see if definitive surgery can be done. If
the tumor extends to areas that would be difficult or hazardous to remove surgically, then the treatment is
usually radiotherapy.
• The radiotherapy dosage must be quite high in all cases.
