Why does the tumor camouflage itself for a long time?
The paranasal sinuses are bony cavities filled with air. A tumor growing inside such a cavity does not encounter obstacles for a long time and does not cause noticeable symptoms, except those that are usual for sinusitis: congestion, discharge, heaviness in the face. Specific complaints appear when the neoplasm begins to destroy the walls of the sinus and extend beyond its limits: to the orbit, to the oral cavity, to the base of the skull. That is why, in case of persistent unilateral complaints that do not respond to standard treatment, it is necessary to examine the nasal cavity with an endoscope and perform a CT scan.
- The tumor grows inside the bone cavity without symptoms
- The complaints are initially indistinguishable from sinusitis
- One-sidedness is a key warning sign
- Specific symptoms appear when going beyond the sinus
- Endoscopy and CT detect tumors at an earlier stage
Causes and risk factors
This is one of the few tumors with a clearly proven professional nature. Significantly increasing the risk is long-term inhalation of wood dust when working with wood and furniture, dust from leather tanning, nickel and chromium compounds, and formaldehyde. Smoking increases the likelihood of squamous cell forms. Some tumors are associated with human papillomavirus infection and with inverted papilloma, a benign formation of the nasal cavity that is prone to degeneration. Chronic sinusitis itself does not become cancer, but it makes timely recognition of the tumor difficult.
- Wood dust in woodworking
- Tanning dust
- Nickel and chromium compounds
- Formaldehyde and paints and varnishes
- Smoking
- Inverted papilloma of the nasal cavity
- Human papillomavirus infection
Symptoms as the tumor grows
At an early stage, this is one-sided nasal congestion, light mucous or bloody discharge, decreased sense of smell, and a feeling of fullness in the cheek. When it spreads towards the orbit, lacrimation, double vision, forward or upward displacement of the eye, and decreased vision appear. Growth downwards towards the oral cavity is manifested by pain and numbness of the upper teeth, their loosening, a poorly healing socket after extraction, and also by the fact that the removable denture no longer fits. Posterior growth causes persistent headache and numbness of half the face.
- Unilateral congestion and bleeding
- Decreased sense of smell
- Pain and swelling in the cheek
- Watery eyes and double vision
- Eyeball displacement
- Numbness of the face and upper teeth
- Deformation of the face and palate in common forms
Diagnostics
The examination begins with endoscopy of the nasal cavity, which allows you to see the formation and take a biopsy; histological examination is mandatory, since in this area there are tumors of a wide variety of structures, and treatment depends on the type. CT scan of the paranasal sinuses shows the condition of the bone walls and destruction of the septa, and MRI better distinguishes tumor tissue from accumulated mucus and assesses growth into the orbit and cranial cavity. Ultrasound of the neck lymph nodes with puncture is needed to assess the prevalence. A conventional x-ray of the sinuses is not sufficient for this task.
- Endoscopy of the nasal cavity with biopsy
- Histological examination
- CT scan of the paranasal sinuses
- MRI with contrast
- CT scan of the orbits for eye symptoms
- Ultrasound of neck lymph nodes and puncture
- Examination to exclude distant lesions
Treatment and prevention
The main method for most tumors in this area remains surgical removal. Many interventions today are performed endoscopically through the nose, without incisions on the face, which significantly facilitates recovery; For advanced tumors, open approaches are used followed by reconstruction. Radiation therapy is given after surgery and, for some types, as the primary treatment. For common forms, radiation is combined with chemotherapy. Prevention - compliance with the rules of respiratory protection at work, quitting smoking and timely removal of inverted papilloma.
- Endoscopic tumor removal through the nose
- Open operations with reconstruction for common forms
- Radiation therapy after surgery or as the main method
- Chemoradiation treatment for advanced stages
- Respirators and exhaust hood when working with wood dust
- Quitting smoking
- Removal and observation of inverted papilloma
