What are the symptoms of paranasal sinus cancer?

One-sided nasal blockage, bloody nasal discharge, facial pain or swelling, numbness of the cheek, loose upper teeth and changes in vision are the most common warning signs. The one-sided, persistent nature of the symptoms distinguishes them from ordinary sinusitis.

Can paranasal sinus cancer be removed endoscopically?

Many tumours can be removed through the nose using endoscopic techniques, with no facial incision. Larger or more extensive cancers, particularly those involving the cheek bone, palate or orbit, may need a combined open and endoscopic approach.

Will I need radiotherapy after sinus cancer surgery?

In most cases, yes. Because the sinuses are surrounded by critical structures, margins are often close, and radiotherapy after surgery substantially improves control. Modern techniques spare the eyes and brain as much as possible.

Rarely. The eye is preserved whenever the tumour has not invaded the eye muscles or the eyeball, even if it touches the orbital wall. Removal of the eye is considered only when it is the only way to clear the cancer, and this is discussed openly before surgery.

Will there be a scar on my face?

Not with endoscopic surgery. When an open approach is needed, the incision runs beside the nose and under the eye along natural lines and fades well. Combined approaches through the nose and upper lip can often avoid a facial scar altogether.

What is the outlook for paranasal sinus cancer?

It depends on the type and stage. Early tumours treated with complete surgery and radiotherapy have five-year survival of 60 to 80 percent. Advanced tumours involving the skull base or orbit have lower survival, which is why persistent one-sided nasal symptoms should be investigated promptly.

Paranasal Cancer Specialist in Ahmedabad

Paranasal sinus cancer surgery in Ahmedabad, planned to protect the eye, face and skull base.

Paranasal sinus cancers grow in the air-filled spaces around the nose and are often mistaken for chronic sinusitis until they spread. Because they sit close to the eye, brain and facial bones, surgery calls for specialist skull base expertise. Dr. Parin Patel uses endoscopic and open approaches to remove these tumours completely while preserving vision and appearance wherever possible.

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What is paranasal sinus cancer?

The paranasal sinuses are four pairs of air-filled cavities in the bones around the nose: the maxillary sinuses in the cheeks, the ethmoid sinuses between the eyes, the frontal sinuses in the forehead and the sphenoid sinuses at the centre of the skull. Paranasal sinus cancer is a malignant tumour arising from the lining of one of these cavities. The maxillary sinus is by far the most common site, followed by the ethmoid; together with cancers of the nasal cavity itself these are grouped as sinonasal cancers, which our sinus cancer page also covers.

These cancers are uncommon, accounting for a small fraction of head and neck cancers, but they are disproportionately serious. The sinuses are silent spaces, so tumours can grow large before causing symptoms, and they lie against the eye, the skull base, the palate and the facial skin, all of which a growing tumour can invade. Several different cancer types occur here, including squamous cell carcinoma, adenocarcinoma (linked to wood dust exposure), adenoid cystic carcinoma, olfactory neuroblastoma, mucosal melanoma and sinonasal undifferentiated carcinoma, and the type strongly influences treatment.

Symptoms of paranasal sinus cancer

Early symptoms mimic sinusitis, but there are two crucial differences: they affect one side only, and they persist and progress despite treatment.

One-sided nasal blockage that does not clear
Blood-stained nasal discharge or recurrent nosebleeds from one side
Reduced sense of smell
Pain, pressure or fullness in the cheek, around the eye or in the forehead
Numbness of the cheek, upper lip or upper teeth
Loose upper teeth, a swelling of the palate or a denture that no longer fits
Swelling of the cheek or face, or a visible mass in the nose
Watering of the eye, double vision, bulging or displacement of the eye, or loss of vision
A lump in the neck (less common than in other head and neck cancers)

Causes and risk factors

Occupational exposure is the most distinctive risk factor: hardwood and softwood dust (furniture and carpentry), leather dust, nickel, chromium, formaldehyde and textile fibres all increase risk, particularly for adenocarcinoma. Tobacco smoking increases the risk of squamous cell carcinoma. HPV is implicated in a subset of cases, and long-standing inverted papilloma, a benign sinonasal tumour, can transform into cancer. Men over 50 are most often affected. Our article on genetic insights in sinus cancer discusses how tumour biology is starting to guide personalised treatment.

Diagnosis and staging

01
Nasal endoscopy
A rigid or flexible endoscope in the clinic shows the nasal cavity and the openings of the sinuses. A visible mass is biopsied under local anaesthesia at the same visit when it is safe to do so.
02
CT scan of the sinuses
Fine-cut CT shows the bony walls of the sinuses, the orbit and the skull base, and whether they are eroded. It is also the map for surgical navigation.
03
MRI with contrast
MRI distinguishes tumour from retained secretions, and shows invasion of the orbital contents, the dura and the brain, and spread along nerves, all of which determine the surgical approach.
04
Biopsy, staging and tumour board
The histological type is confirmed and, for some tumours, molecular markers are tested. A CT of the chest or PET-CT completes staging. The case is then discussed with neurosurgery, ophthalmology, radiation and medical oncology.

Paranasal sinus cancer treatment in Ahmedabad

For most sinonasal cancers, surgery to remove the tumour completely followed by radiotherapy gives the best chance of cure. Some types, such as sinonasal undifferentiated carcinoma and lymphoma, are treated primarily with chemotherapy and radiotherapy, and chemotherapy may be given first to shrink very advanced tumours. Dr. Parin Patel plans each case with the tumour board at HCG Aastha Cancer Centre and matches the operation to the extent of disease.

Endoscopic resection

Tumours confined to the nasal cavity, ethmoid sinuses and medial maxillary sinus can often be removed entirely through the nose using the techniques of endoscopic skull base surgery, including removal of the anterior skull base and dura when they are involved, with reconstruction using a nasoseptal flap. This avoids facial incisions and shortens recovery, with cancer control equal to open surgery for suitable tumours. Our article on the latest minimally invasive sinus cancer surgery options explains which tumours qualify.

Maxillectomy

Cancers of the maxillary sinus that involve the cheek bone, palate or orbital floor are removed by partial or total maxillectomy, through an incision beside the nose that heals to a fine line, or increasingly through a combined endoscopic and sublabial approach without a facial scar. The palate and orbital floor are reconstructed with a free flap or a dental obturator so that eating and speech are restored and the eye is supported.

Craniofacial resection and orbital management

Tumours that have invaded the skull base extensively or the brain are removed by a combined approach with neurosurgery, from above and below, as described on our skull base surgery page. When a tumour touches the orbit, every effort is made to preserve the eye; the eye is removed only when the tumour has invaded the eye muscles or the eyeball itself, and this is discussed frankly beforehand.

Reconstruction and radiotherapy

Defects are reconstructed in the same operation with local, regional or microvascular free flaps to restore the facial contour, the palate and the barrier between nose and brain; see reconstructive surgery. Radiotherapy, using intensity-modulated or proton techniques to spare the eyes and brain, usually follows surgery within six weeks. For a broader overview, read our complete guide to paranasal cancer surgery in Ahmedabad.

Why Dr. Parin Patel

Skull Base Surgery Fellowship at Tata Memorial Centre, Mumbai, with training in both endoscopic and open sinonasal cancer surgery
Fellowship-trained Head and Neck Surgical Oncologist with more than thirteen years of experience
Multidisciplinary sinonasal tumour board with neurosurgery, ophthalmology, radiation and medical oncology at HCG Aastha Cancer Centre
Eye-preserving and face-preserving surgical planning wherever oncologically safe
Immediate reconstruction, dental rehabilitation and structured follow-up

Recovery after sinus cancer surgery

After endoscopic resection, most patients go home within three to five days, with nasal crusting managed by saline rinses and clinic clean-outs for several weeks. After maxillectomy with reconstruction, the stay is about a week; eating begins with liquids and progresses as the palate heals, and an obturator, if used, is fitted and adjusted by the prosthodontist. After craniofacial resection, the stay is seven to ten days with a period of monitoring. Swelling and numbness of the cheek improve over months. Radiotherapy follows once healing is complete, and rehabilitation addresses any effects on speech, swallowing or eye comfort. Follow-up endoscopy and imaging continue for at least five years.

Sinus cancer specialistNasal cavity and sinus cancers, minimally invasive options.Endoscopic skull base surgeryThrough-the-nose tumour removal.Skull base surgeryCombined and open approaches.Craniofacial surgeryFacial reconstruction after maxillectomy.Reconstructive surgeryFree-flap palate and orbit reconstruction.Book a consultationEndoscopy and scan review at the first visit.

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