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Sinus Cancer

Understanding the Anatomy

The paranasal sinsuses are air-filled spaces in the head. The sinuses are very closely related to some major structures. They are close to the brain, the eyes, the carotid artery, the teeth and important nerves in the head and neck area.

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There are four pairs of sinuses.

  • Maxillary sinus: This is the cheek sinus. This sinus is located above your teeth, below your eye and next to your nose. There is one on each side. This is the biggest sinus. There is a little drainage hole so all the mucous made in the sinus can drain into your nasal cavity just under the middle turbinate. The maxillary sinus is the most common site for a sinonasal cancer.
  • Ethmoid sinuses: This is a group of 10-20 small sinuses with very thin walls that sit basically between the eyes and the nasal septum. The eye (actually the orbit) is to one side of the ethmoid sinus, and there is just a thin piece of bone that separates the two. This, along with the nasal cavity, is tied for being the second most common site of sinonasal cancer. Mucous from the ethmoid sinuses drains into the nasal cavity, under both the middle and superior turbinates.
  • Frontal sinus: This sinus (also one on each side) is located behind the forehead and over the eye. It drains just below the middle turbinate through a passageway called the nasofrontal duct.
  • Sphenoid sinus: This sinus is located behind the nose at the base of the skull. Many important structures are found just behind the sphenoid sinus, including the brain, the nerve of vision, and the main blood vessel to the brain (the carotid artery). The mucous from here empties just below the superior turbinate into the nasal cavity.

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The exact functions of the sinuses are not clear, but it is thought that they play a role in:

  • Humidification of the air
  • Keeping the head light in weight
  • Making the voice resonate as it does
  • Maybe even preventing hits or falls on the face from causing major skull damage

 

References

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2 Leclerc A, Martinez Cortes M, Gérin M, Luce D, Brugère J. Sinonasal cancer and wood dust exposure: results from a case-control study. Am J Epidemiol. 1994 Aug 15;140(4):340-9.

3 Brinton LA, Blot WJ, Becker JA, Winn DM, Browder JP, Farmer JC Jr, Fraumeni JF Jr. A case-control study of cancers of the nasal cavity and paranasal sinuses. Am J Epidemiol. 1984 Jun;119(6):896-906.

4 Battista G, Comba P, Orsi D, Norpoth K, Maier A. Nasal cancer in leather workers: an occupational disease. J Cancer Res Clin Oncol. 1995;121(1):1-6.

5 Spiro RH, Thaler HT, Hicks WF, Kher UA, Huvos AH, Strong EW. The importance of clinical staging of minor salivary gland carcinoma. Am J Surg. 1991 Oct;162(4):330-6.

6 Katz TS, Mendenhall WM, Morris CG, Amdur RJ, Hinerman RW, Villaret DB. Malignant tumors of the nasal cavity and paranasal sinuses. Head Neck. 2002 Sep;24(9):821-9.

7 Wieneke JA, Thompson LD, Wenig BM. Basaloid squamous cell carcinoma of the sinonasal tract. Cancer. 1999 Feb 15;85(4):841-54.

8 Marcus DM, Marcus RP, Prabhu RS, Owonikoko TK, Lawson DH, Switchenko J, Beitler JJ. Rising incidence of mucosal melanoma of the head and neck in the United States. J Skin Cancer. 2012;2012:231693. doi: 10.1155/2012/231693. Epub 2012 Dec 2.

9 Edge SB, et al. The AJCC Cancer Staging Manual – Seventh Edition. American Joint Committee on Cancer 2010. Chapter 9: Mucosal Melanoma of the Head and Neck.

10 Ejaz A, Wenig BM. Sinonasal undifferentiated carcinoma: clinical and pathologic features and a discussion on classification, cellular differentiation, and differential diagnosis. Adv Anat Pathol. 2005 May;12(3):134-43.

11 Perez-Ordonez B, Caruana SM, Huvos AG, Shah JP. Small cell neuroendocrine carcinoma of the nasal cavity and paranasal sinuses. Hum Pathol. 1998 Aug;29(8):826-32.

12 Spiro JD, Soo KC, Spiro RH. Nonsquamous cell malignant neoplasms of the nasal cavities and paranasal sinuses. Head Neck. 1995;17:114-118.

13 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed December 6, 2016. To view the most recent and complete version of the guideline, go online to www.NCCN.org.

14 Piccirillo JF, Costas I, Reichman ME. Chapter 2: Cancers of the Head and Neck. Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.

15 Jethanamest D, Vila PM, Sikora AG, Morris LG. Predictors of survival in mucosal melanoma of the head and neck. Ann Surg Oncol. 2011 Oct;18(10):2748-56.