Paranasal sinus cancer: A better knowledge about your nasal cavity and paranasal sinuses will help you in understanding the cancers that affect both your nasal cavity and paranasal sinuses.

The nasal cavity

Nasal cavity or the nasal passage is the cavity or space that runs along the roof of the mouth or palate. Your nostrils lead into this cavity. Nasal cavity runs down to join the passage from the mouth to the throat.

The paranasal sinuses

Sinuses are spaces or cavities or, in other words – small tunnels that are present near or around the nose (paranasal sinuses). Nasal cavity leads into a network of sinuses including maxillary sinuses (present in the cheek area); frontal sinuses (near eyes); sphenoid sinuses (between the eyes and behind the nose) and ethmoid sinuses (between the eyes and above the nose). Sinuses perform many functions along with the nasal cavity, such as moisten, warm and filter the air we breathe; help resonate the voice and provide a bony framework for the face and eyes.

The cells that line the paranasal sinuses and nasal cavity are mucus producing cells (mucosa). Several types of cells are present in the mucosa including squamous epithelial cells, glandular cells, nerve cells and infection fighting cells.

The nasal cavity and paranasal sinuses are filled with air. In a normal healthy individual air freely moves inside them, but when a person gets flu, cold or sinus infection, sinuses become blocked or obstructed and get filled with mucus and sometimes pus – which can be uncomfortable for the patient.

Nasal cavity and paranasal sinus cancers

Any type of cell in the nasal cavity and paranasal sinuses can become cancerous – even cartilage cells and bone cells as well. However, majority (almost 60%) of the cancers in the nasal cavity and paranasal sinuses are squamous cell Carcinomas – wherein squamous epithelial cells turn into cancerous cells. Other types of nasal and paranasal sinus cancers include mucoepidermoid cancer, adenoid cystic carcinomas and adenocarcinomas. Mucosal cells can also turn into an undifferentiated carcinoma – which is a fast-growing cancer.

Melanoma is a type of skin cancer that usually develop on the skin areas exposed to sunlight, but melanoma can also develop in the mucosal cells of the nasal cavity and sinuses, and then grow and spread rapidly to the other areas of the body.

Lymphomas – the cancers that begin in the immune system cells can develop in the nasal cavity and paranasal sinuses. One such cancer is nasal-type lymphoma. Sarcomas can also begin in the nasal cavity and paranasal sinuses. Olfactory neuroblastoma or Esthesioneuroblastoma is a type of cancer that starts in the nerve for the sense of smell (olfactory nerve). It begins in the roof of the nasal cavity. This type of tumour can be mistaken for other type of lymphoma or undifferentiated carcinoma.

The above types of cancers have their own distinct outlook and behaviour. Surprisingly, many of them may or may not affect the nasal cavity and paranasal sinuses. Furthermore, they all cannot be treated alike. Owing to their distinct behaviour and outlook, it is pertinent for the treating head and neck surgeon to make treatment decisions based on their experience and expertise.