Carcinoma of Maxillary Sinus

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  • Carcinoma of Maxillary Sinus
    • Most common histology – squamous cell carcinoma (MCQ) 
    • Nodal metastases are uncommon and occur only in the late stages of disease.
    • CT scan. is the best non-invasive method to find the extent of disease.
    • Caldwell-Luc operation. Direct visualisation of the site of tumour in the sinus also helps in staging of the tumour.
    • Ohngren’s classification.
      • An imaginary plane is drawn, extending between medial canthus of eye and the angle of mandible
      • Growths situated above this plane (suprastructural) have a poorer prognosis than those below it (intrastructural).
    • For squamous cell carcinoma, a combination of radiotherapy and surgery gives better results than either alone.
      • Radiotherapy can be given before or after surgery.
      • Very often, a full course of pre-operative telecobalt therapy is given, followed 4-6 weeks later by surgical excision of the growth by total or extended maxillectomy (MCQ)
  • Ethmoid Sinus Malignancy
    • Ethmoid sinuses are often involved from extension of the primary growths of the maxillary sinus.
    • Adenocarcinoma of ethmoid sinus occur’s commonly in Wood workers (MCQ)
    • Nickle workers have a high incidence of carcinoma of Ethmoid sinuses (MCQ)
    • Treatment
      • In early cases, treatment is pre-operative radiation, followed by lateral rhinotomy and total ethmoidectomy.
      • If cribriform plate is involved, anterior cranial fossa is exposed by a neurosurgeon and total exenteration of the growth in one piece is accomplished by what is called craniofacial resection.


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