title: Management of paranasal sinus malignancy.
abstract: Malignancies of the nasal cavity and paranasal sinuses represent a wide spectrum of histologies, tissues of origin, and anatomic primary sites. The inherent difficulty in generalizing treatment approaches is obvious, given the numerous variables associated with the broadly-based term, paranasal sinus malignancy (PNSCa). Nevertheless, the majority of epithelial and salivary malignancies of this region (ie, squamous cell carcinoma, adenocarcinoma, adenoid cystic carcinoma, sinonasal undifferentiated carcinoma, and esthesioneuroblastoma) require surgical intervention as part of any treatment regimen. Recent trends have broadened the indications for chemotherapeutic and radiotherapeutic options in the management of advanced PNSCa. Nonepithelial malignancies, including the wide variety of sarcomas arising in this region, most commonly require multimodality treatment including chemotherapy, radiation, and/or surgery for definitive treatment. Moreover, the proximity of the nasal cavity and paranasal sinuses to structures including the orbit, dura, brain, cranial nerves, and carotid arteries mandates careful radiologic and neurologic evaluations throughout the course of the disease. Surgical advances now permit complex tumor removal and reconstruction surrounding these structures resulting in functional and cosmetic improvements when compared to earlier techniques. However, additional clinical trials are necessary to systematically evaluate the locoregional control, organ-preservation strategies, and survival related to the variety of treatments currently available.
authors.affiliation: Head and Neck Tumor Program, Hollings Cancer Center, Medical University of South Carolina, 96 Jonathan Lucas Street, Charleston, SC 29425, USA. dayt@musc.edu
authors.forename: Terry A
authors.initials: TA
authors.lastname: Day
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Beas
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Schlosser
authors.forename: Bradford A
authors.initials: BA
authors.lastname: Woodworth
authors.forename: Julio
authors.initials: J
authors.lastname: Barredo
authors.forename: Anand K
authors.initials: AK
authors.lastname: Sharma
authors.forename: M Boyd
authors.initials: MB
authors.lastname: Gillespie
mesh_terms: D000328:Adult; D000367:Age Factors; D002277:Carcinoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002648:Child; D003131:Combined Modality Therapy; D004032:Diet; D006801:Humans; D008019:Life Style; D008545:Melanoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000601:surgery*; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures; D012509:Sarcoma / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*