Sinonasal Tumours

Overview

The sinonasal region refers to the nasal cavity and the network of sinuses surrounding it. This area sits behind the eyes and the nose, meaning its closely located to the inner workings of the eyes, the cranial nerves and the brain. Sinonasal tumours can be malignant (cancerous) or benign (non-cancerous), but all cause significant symptoms and require highly specialised care.

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About Sinonasal Tumours

Patients experience symptoms such as nasal obstruction, nosebleeds, reduced sense of smell, facial pressure, headaches, double vision or even visible changes in the shape of the face. This is because, in some cases, tumours can extend sideways/outwards into the facial structures.

Sinonasal tumours are rare and can behave unpredictably, which is why diagnosis and treatment planning are carried out by a multidisciplinary skull base team with expertise in ENT, neurosurgery, oncology, radiology and pathology is critical. They can be malignant (cancerous) or benign (non-cancerous):

Benign (Non-Cancerous) Tumours

These do not spread to other parts of the body, but they can still cause significant symptoms because they grow close to important nerves and blood vessels:

Schwannomas / Neuromas – Benign tumours that grow from the protective covering of nerves. They can occur on different cranial nerves and are labelled accordingly: Facial feeling (cranial nerve V), Facial movement (cranial nerve VII), Hearing and balance (cranial nerve VIII), Swallowing and taste (cranial nerve IX), Voice and breathing control (cranial nerve X), Shoulder and neck movement (cranial nerve XI), Tongue movement (cranial nerve XII)
Paragangliomas (glomus tumours) – Usually benign, but these tumours can be complicated as they may grow into nearby structures, they include Glomus jugulare, Glomus tympanicum and Glomus vagale

Neurofibromas – Benign nerve tumours, sometimes linked to the genetic condition neurofibromatosis

Salivary gland tumours – Some are benign (e.g. pleomorphic adenoma), especially those located in the parotid gland or parapharyngeal space.

Malignant (Cancerous) Tumours

These can invade nearby tissues and may spread to other parts of the body:

Temporal bone carcinoma – a rare cancer that starts in the bone around the ear
External auditory canal carcinoma – cancer that begins in the skin of the ear canal
Malignant parotid gland tumours – such as mucoepidermoid carcinoma or adenoid cystic carcinoma, which can grow towards the ear canal or to the skull base
Tumours extending into the skull base – cancers from nearby areas (such as the parotid gland, skin of the ear or scalp) may grow into the ear canal, the temporal bone or even down to the skull base

While not a tumour itself, occasionally patients will suffer from a cerebrospinal fluid (CSF) leak as a result of an ear canal tumour. This could be due to erosion by the tumour or from a previous surgery. The fluid may leak around the brain through a defect in the temporal bone and may need repair, click here to learn more.

Sinonasal Tumour Treatments

Treatment depends on the tumour type, location and extent, but typically involves a combination of surgery and cancer treatment for malignant tumours. The most common surgery for sinonasal tumours is Endoscopic endonasal surgery (EES) or keyhole surgery (performed through the nostrils with no external incisions).

However, when tumours extend into the skull base, eye sockets or brain then open surgical approaches may be needed. Here incisions may be hidden along the side of the nose or along the eyebrow or hairline. The Skull Base Specialists teams include experts in facial plastics who can help with reconstruction after the tumour removal. Because Sinonasal Tumours can recur patients should be monitored by specialists after their surgery, with follow up endoscopy or imaging (MRI/CT). Read more about Skull Bae Specialists’ cutting-edge treatments for Sinonasal tumours here.

Overview