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The paranasal sinuses are hollow spaces surrounding the nose (nasal cavity) and eyes. The skull base is the boney structure behind the eyes and nose that separates the brain from the other facial structures. Tumors can involve these structures, as well as the eyes, nose, face and roof of the mouth.

Nose and Sinus Diagram

Sinus and skull base cancers are relatively rare and highly complex. Each patient requires an individualized treatment approach delivered by a team of highly experienced, multidisciplinary team. Types of cancers that can be found in these areas include:

  • Squamous cell carcinoma — most common type
  • Sinonasal undifferentiated carcinoma
  • Esthesioneuroblastoma
  • Adenoid cystic carcinoma or acinic cell carcinoma
  • Chondrosarcoma
  • Chordoma
  • Inverted papilloma
  • Lymphoma

Symptoms

  • Nosebleeds
  • Sinus problems — facial pressure/pain, nasal drainage, nasal blockage
  • Vision changes
  • Non-healing sore on the roof of the mouth
  • Facial contour changes
  • Facial numbness or tingling
  • Dental pain or loose teeth
  • Headaches

Risk Factors

Exposure to relatively rare workplace chemicals or particulate matter in some cases may increase the risk for paranasal sinus and skull base cancers. At-risk occupations include carpentry, shoemaking, metal-plating and flour milling. The risk is also higher in people infected with human papillomavirus (HPV) and in men older than 40 who smoke.

Diagnosis

As part of the initial visit, the following tests may be used to detect, diagnose and/or stage a sinus, nasal or skull base cancer.

  • Discussion of current symptoms, past medical history, and health habits
  • Physical examination: an exam to check the eyes, nose, face, mouth and neck
  • Endoscopy: a slender camera may be used after appropriate numbing through the nose to look into the nasal cavity and/or paranasal sinuses
  • Biopsy: to obtain a definitive diagnosis, which may require a brief outpatient trip to the operating room
  • Imaging: may include CT scan, MRI and/or PET scan

Treatment Options

Depending on the type, extent and location of the tumor, patients may require surgery, radiation therapy and/or chemotherapy or a combination of these treatments. Surgical options often include minimally invasive endoscopic surgery with image guidance that is carried out through the nose with no visible incisions. Other options may include highly specialized radiation treatments such IMRT (intensity-modulated radiation therapy), TomoTherapy® and/or Gamma Knife®. Our multidisciplinary team has the ability to offer all of these treatment options with the experience and expertise to help guide patients through this complex care.

During and after treatment, the Head and Neck Cancer Program’s team of speech-language pathologists, physical and occupational therapists, audiologists, dietitians and other supportive care specialists provide patients with individualized, best-practice therapy and rehabilitation These skilled members of our multidisciplinary team help to ensure patients achieve the best functional outcomes possible. Additionally, patients have access to the varied patient support resources available.

Treatment Team

We have a collaborative team of highly skilled specialists with experience in treating patients with challenging cases of paranasal sinus and skull base cancers. Members of your treatment team may include:

  • Otolaryngologists, including head and neck oncologic surgeons and rhinologists/skull base surgeons
  • Neurosurgons
  • Radiation oncologists
  • Medical oncologists
  • Neurologists
  • Interventional neuroradiologists
  • Oculoplastic surgeons

Virtual Visits Are Available

Safe and convenient virtual visits by video let you get the care you need via a mobile device, tablet or computer wherever you are. We’ll gather your medical records for you and get our experts’ input so we can offer treatment options without an in-person visit. To schedule a virtual visit, call 1-866-680-0505.

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Cancer and the COVID-19 Vaccine

There is currently no data that suggests current or former cancer patients should avoid getting the COVID-19 vaccine. Cancer can weaken your immune system, so we recommend that most patients get the vaccine as soon as possible.