Hostname: page-component-848d4c4894-jbqgn Total loading time: 0 Render date: 2024-06-16T00:33:06.289Z Has data issue: false hasContentIssue false

Sinonasal malignancy: presentation and outcomes

Published online by Cambridge University Press:  23 June 2014

Y B Mahalingappa
ENT Department, Plymouth Hospitals NHS Trust, UK
H S Khalil*
ENT Department, Plymouth Hospitals NHS Trust, UK Plymouth University Peninsula School of Medicine and Dentistry, UK
Address for correspondence: Professor Hisham Khalil, ENT Department, Level 7, Derriford Hospital, Plymouth, PL6 8DH, United Kingdom Fax: +44 (0) 175 276 3185 E-mail:



We wanted to identify the presentation, diagnostic work-up and treatment outcomes of patients with sinonasal malignancy at Derriford Hospital, Plymouth, UK and compare these with the European Position Paper on Endoscopic Management of Tumours of the Nose, Paranasal Sinuses and Skull Base.

Materials and methods:

This was a retrospective audit of all patients diagnosed with sinonasal malignancy over a five-year period. The clinical records and picture archiving and communications system data of the patients were reviewed.


Thirty patients with sinonasal malignancy were identified out of 570 head and neck cancer patients. The nasal cavity was the most common site for presentation, followed by the maxillary sinuses. Fifty per cent of patients had a squamous cell carcinoma and 27 per cent had a malignant melanoma. Half of the patients presented at stage IV of the cancer and 20 per cent at stage III. Thirty-seven per cent of patients underwent surgical management and only 20 per cent of the total patient group underwent endoscopic surgery. The mortality in our series was 30 per cent over the studied period.


Late-stage presentation of sinonasal malignancy has resulted in increased patient mortality in our case series. Also, we found a high incidence of malignant melanoma with high recurrence and survival rates.

Main Articles
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


1Tufano, RP, Mokadam, NA, Montone, KT, Weinstein, GS, Chalian, AA, Wolf, PF et al. Malignant tumors of the nose and paranasal sinuses: hospital of the University of Pennsylvania experience 1990–1997. Am J Rhinol 1999;13:117–23CrossRefGoogle ScholarPubMed
2Rinaldo, A, Ferlito, A, Shaha, AR, Wei, WI. Is elective neck treatment indicated in patients with squamous cell carcinoma of the maxillary sinus? Acta Otolaryngol 2002;122:443–7Google Scholar
3Le, QT, Fu, KK, Kaplan, M, Terris, DJ, Fee, WE, Goffinet, DR. Treatment of maxillary sinus carcinoma: a comparison of the 1997 and 1977 American Joint Committee on cancer staging systems. Cancer 1999;86:1700–113.0.CO;2-4>CrossRefGoogle ScholarPubMed
4Tiwari, R, Hardillo, JA, Mehta, D, Slotman, B, Tobi, H, Croonenburg, E et al. Squamous cell carcinoma of maxillary sinus. Head Neck 2000;22:164–9Google Scholar
5Office for National Statistics. Cancer Statistics Registrations, England 2003: Registrations of Cancer Diagnosed in 2003, England. Series MB1 No. 34. London: Office for National Statistics, 2005Google Scholar
6Muir, CS, Nectoux, J. Descriptive epidemiology of malignant neoplasms of nose, nasal cavities, middle ear and accessory sinuses. Clin Otolaryngol Allied Sci 1980;5:195211Google Scholar
7Lund, VJ, Stammberger, H, Nicolai, P, Castelnuovo, P, Beal, T, Beham, A et al. European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol Suppl 2010;22:1143Google Scholar
8Zyłka, S, Bień, S, Kamiński, B, Postuła, S, Ziołkowska, M. Epidemiology and clinical characteristics of the sinonasal malignancies [in Polish]. Otolaryngol Pol 2008;62:436–41Google ScholarPubMed
9Barbieri, PG, Lombardi, S, Candela, A, Festa, R. Nasal sinus cancer registry of the province of Brescia [in Italian]. Epidemiol Prev 2003;27:215–20Google Scholar
10Brent, AM, Michael, G. Nasal cavity and paranasal sinus malignancy. In: Micheal, G, George, GB, Ray, C, Valerie, JL, John, CW, eds. Scott-Brown's Otolaryngology, Head and Neck Surgery, 7th edn.London: Hodder Arnold P, 2008;2417–36Google Scholar
11Svane-Knudsen, V, Jørgensen, KE, Hansen, O, Lindgren, A, Marker, P. Cancer of the nasal cavity and paranasal sinuses: a series of 115 patients. Rhinology 1998;36:1214Google ScholarPubMed
12Zbären, P, Richard, JM, Schwaab, G, Mamelle, G. Malignant neoplasms of the nasal cavity and paranasal sinuses. Analysis of 216 cases of malignant neoplasms of nasal cavity and paranasal sinuses [in German]. HNO 1987;35:246–9Google ScholarPubMed
13Haraguchi, H, Ebihara, S, Saikawa, M, Mashima, K, Haneda, T, Hirano, K. Malignant tumors of the nasal cavity: review of a 60-case series. Jpn J Clin Oncol 1995;25:188–94Google Scholar
14Van Hasselt, CA, Skinner, DW. Nasopharyngeal carcinoma. An analysis of 100 Chinese patients. S Afr J Surg 1990;28:92–4Google ScholarPubMed
15Lund, VJ. Malignancy of the nose and sinuses. Epidemiological and aetiological considerations. Rhinology 1991;29:5768Google Scholar
16Spiro, JD, Soo, KC, Spiro, RH. Nonsquamous cell malignant neoplasms of the nasal cavities and paranasal sinuses. Head Neck 1995;17:114118CrossRefGoogle ScholarPubMed
17Kassam, A, Snyderman, CH, Mintz, A, Gardner, P, Carrau, RL. Expanded endonasal approach: the rostrocaudal axis. Part I. Crista galli to the sella turcica. Neurosurg Focus 2005;19:E3Google Scholar
18Kassam, A, Snyderman, CH, Mintz, A, Gardner, P, Carrau, RL. Expanded endonasal approach: the rostrocaudal axis. Part II. Posterior clinoids to the foramen magnum. Neurosurg Focus 2005;19:E4Google Scholar
19Kassam, AB, Gardner, P, Snyderman, C, Mintz, A, Carrau, R. Expanded endonasal approach: fully endoscopic, completely transnasal approach to the middle third of the clivus, petrous bone, middle cranial fossa, and infratemporal fossa. Neurosurg Focus 2005;19:E6CrossRefGoogle Scholar
20Carrabba, G, Dehdashti, AR, Gentili, F. Surgery for clival lesions: open resection versus the expanded endoscopic endonasal approach. Neurosurg Focus 2008;25:E7Google Scholar
21Dehdashti, AR, Ganna, A, Witterick, I, Gentili, F. Expanded endoscopic endonasal approach for anterior cranial base and suprasellar lesions: indications and limitations. Neurosurgery 2009;64:677–87Google Scholar
22Fatemi, N, Dusick, JR, de Paiva Neto, MA, Malkasian, D, Kelly, DF. Endonasal versus supraorbital keyhole removal of craniopharyngiomas and tuberculum sellae meningiomas. Neurosurgery 2009;64:269–84Google ScholarPubMed
23Lee, CH, Hur, DG, Roh, HJ, Rha, KS, Jin, HR, Rhee, CS et al. Survival rates of sinonasal squamous cell carcinoma with the new AJCC staging system. Arch Otolaryngol Head Neck Surg 2007;133:131–4CrossRefGoogle ScholarPubMed
24Dauer, EH, Lewis, JE, Rohlinger, AL, Weaver, AL, Olsen, KD. Sinonasal melanoma: a clinicopathologic review of 61 cases. Otolaryngol Head Neck Surg 2008;138:347–52CrossRefGoogle ScholarPubMed
25Mendenhall, WM, Amdur, RJ, Hinerman, RW, Werning, JW, Villaret, DB, Mendenhall, NP. Head and neck mucosal melanoma. Am J Clin Oncol 2005;28:626–30Google Scholar
26Lund, VJ, Howard, DJ, Harding, L, Wei, WI. Management options and survival in malignant melanoma of the sinonasal mucosa. Laryngoscope 1999;109:208–11Google Scholar
27Wagner, M, Morris, CG, Werning, JW, Mendenhall, WM. Mucosal melanoma of the head and neck. Am J Clin Oncol 2008;31:43–8CrossRefGoogle ScholarPubMed