Skip to main content Accessibility help

Sinonasal malignancy: presentation and outcomes

  • Y B Mahalingappa (a1) and H S Khalil (a1) (a2)



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.


Corresponding author

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:


Hide All
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;13:117–23
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;122:443–7
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;86:1700–11
4Tiwari, R, Hardillo, JA, Mehta, D, Slotman, B, Tobi, H, Croonenburg, E et al. Squamous cell carcinoma of maxillary sinus. Head Neck 2000;22:164–9
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, 2005
6Muir, CS, Nectoux, J. Descriptive epidemiology of malignant neoplasms of nose, nasal cavities, middle ear and accessory sinuses. Clin Otolaryngol Allied Sci 1980;5:195211
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;22:1143
8Zyłka, S, Bień, S, Kamiński, B, Postuła, S, Ziołkowska, M. Epidemiology and clinical characteristics of the sinonasal malignancies [in Polish]. Otolaryngol Pol 2008;62:436–41
9Barbieri, PG, Lombardi, S, Candela, A, Festa, R. Nasal sinus cancer registry of the province of Brescia [in Italian]. Epidemiol Prev 2003;27:215–20
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;2417–36
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;36:1214
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;35:246–9
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;25:188–94
14Van Hasselt, CA, Skinner, DW. Nasopharyngeal carcinoma. An analysis of 100 Chinese patients. S Afr J Surg 1990;28:92–4
15Lund, VJ. Malignancy of the nose and sinuses. Epidemiological and aetiological considerations. Rhinology 1991;29:5768
16Spiro, JD, Soo, KC, Spiro, RH. Nonsquamous cell malignant neoplasms of the nasal cavities and paranasal sinuses. Head Neck 1995;17:114118
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:E3
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:E4
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:E6
20Carrabba, G, Dehdashti, AR, Gentili, F. Surgery for clival lesions: open resection versus the expanded endoscopic endonasal approach. Neurosurg Focus 2008;25:E7
21Dehdashti, AR, Ganna, A, Witterick, I, Gentili, F. Expanded endoscopic endonasal approach for anterior cranial base and suprasellar lesions: indications and limitations. Neurosurgery 2009;64:677–87
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;64:269–84
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;133:131–4
24Dauer, EH, Lewis, JE, Rohlinger, AL, Weaver, AL, Olsen, KD. Sinonasal melanoma: a clinicopathologic review of 61 cases. Otolaryngol Head Neck Surg 2008;138:347–52
25Mendenhall, WM, Amdur, RJ, Hinerman, RW, Werning, JW, Villaret, DB, Mendenhall, NP. Head and neck mucosal melanoma. Am J Clin Oncol 2005;28:626–30
26Lund, VJ, Howard, DJ, Harding, L, Wei, WI. Management options and survival in malignant melanoma of the sinonasal mucosa. Laryngoscope 1999;109:208–11
27Wagner, M, Morris, CG, Werning, JW, Mendenhall, WM. Mucosal melanoma of the head and neck. Am J Clin Oncol 2008;31:43–8


Sinonasal malignancy: presentation and outcomes

  • Y B Mahalingappa (a1) and H S Khalil (a1) (a2)


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed