Paranasal Sinus and Nasal Cavity Cancer Overview

What are the paranasal sinuses and nasal cavity?

Paranasal sinuses are air-filled spaces in the bones found around the nose.  They are filled with mucous that help keep the nose from drying out while breathing.  There are six sinuses including frontal (two above the eyes), maxillary (two below the eyes), ethmoid and sphenoid (both found at the center, behind the nose).  The nasal cavity is the inner part of the nose and is surrounded by the bones of the skull.  It is separated from the mouth (oral cavity) by the roof of the mouth (palate).  The nasal cavity is lined with mucous.  As air flows through the nasal cavity, it is warmed by the mucous membranes and moistened by mucous.  

What are paranasal sinus and nasal cavity cancer?

Paranasal sinus and nasal cavity cancers are types of head and neck cancer.  These types of cancers are often found late because the patient may not have any signs of the disease, and symptoms may have been confused with those of a nasal infection or allergic reactions (chronic sinusitis).  These cancers can easily grow throughout the sinus area.    The maxillary sinus is the most common sinus involved with cancer. 

The paranasal sinuses and nasal cavity contain different types of cells which can develop into cancer.  Squamous cells line the inside of the paranasal sinuses and nasal cavity.  The most common type of cancer in this area is squamous cell cancer. Other types of paranasal sinuses and nasal cavity cancers include adenocarcinoma, lymphomas, malignant melanomas, and rarely esthesioneuroblastoma. 

Risk factors

Risk factors for developing cancer of the paranasal sinus and nasal cavity include smoking, being male older than 40 years old, infected with the human papillomavirus (HPV), as well as environmental or workplace exposure.  Those who work with wood, leather, flour, or metals such as nickel are at risk for developing paranasal sinus and nasal cavity cancer.

Symptoms

These cancers may have no symptoms in the early stages.  Symptoms may appear as the cancer progresses.  Common symptoms are blocked or congested (stuffy) sinuses and nosebleeds.  Other symptoms include:

  • Headaches or pain in the sinus areas
  • A lump or sore inside the nose that does not heal
  • A lump on the face or roof of the mouth
  • Numbness or tingling in the face
  • Pain in the upper teeth, loose teeth, or dentures that no longer fit well
  • Pain or pressure in the ear

Treatment Options

Treatment of paranasal sinus and nasal cavity cancer can be difficult and requires a thorough evaluation prior to treatment and treatment planning.  Patients with paranasal sinus and nasal cavity cancer should be seen by a team of doctors who specifically treat head and neck cancers.  This medical team includes a medical oncologist, radiation oncologist, oral or head and neck surgeon, plastic surgeon, dentist, registered dietician, and speech therapist.  

Different kinds of treatment are available for paranasal sinus and nasal cavity cancers. Most patients will need a combination of surgery, radiation treatment, and chemotherapy. Patients may also have the option to be treated on a clinical trial which is meant to help improve current treatments (standard of care) or obtain information on new treatments for patients with cancer.  It is important to discuss your treatment options with your physician.    

Recurrent cancer is cancer that has returned after it has been treated.  The cancer may return in the paranasal sinuses and nasal cavity or it may return in other parts of the body. Treatment of recurrent paranasal sinuses and nasal cavity cancer depends on the where the cancer returned and the type of treatment initially received.