1
Neoplasms of theNeoplasms of the
Nose and ParanasalNose and Paranasal
SinusSinusINDIAN DENTAL ACADEMY
Leader in continui...
2
Neoplasms of Nose and ParanasalNeoplasms of Nose and Paranasal
SinusesSinuses
 Very rare 3%Very rare 3%
 Delay in diag...
3
Neoplasms of Nose and ParanasalNeoplasms of Nose and Paranasal
SinusesSinuses
 Multimodality treatmentMultimodality tre...
4
EpidemiologyEpidemiology
 Predominately of older malesPredominately of older males
 Exposure:Exposure:
 Wood, nickel-...
5
LocationLocation
 Maxillary sinusMaxillary sinus
 70%70%
 Ethmoid sinusEthmoid sinus
 20%20%
 SphenoidSphenoid
 3%...
6
PresentationPresentation
 Oral symptoms: 25-35%Oral symptoms: 25-35%
 Pain, trismus, alveolar ridge fullness, erosionP...
7
RadiographyRadiography
 CTCT
 Bony erosionBony erosion
 Limitations with periorbita involvementLimitations with perio...
8
Benign LesionsBenign Lesions
 PapillomasPapillomas
 OsteomasOsteomas
 Fibrous DysplasiaFibrous Dysplasia
 Neurogenic...
9
PapillomaPapilloma
 Vestibular papillomasVestibular papillomas
 Schneiderian papillomas derived fromSchneiderian papil...
10
Inverted PapillomaInverted Papilloma
 4% of sinonasal tumors4% of sinonasal tumors
 Site of Origin: lateral nasal wal...
11
Inverted PapillomaInverted Papilloma
ResectionResection
 Initially via transnasal resection:Initially via transnasal r...
12
OsteomasOsteomas
 Benign slow growing tumors of mature boneBenign slow growing tumors of mature bone
 Location:Locati...
13
Fibrous dysplasiaFibrous dysplasia
 Dysplastic transformation of normal bone withDysplastic transformation of normal b...
14
Neurogenic tumorsNeurogenic tumors
 4% are found within the paranasal sinuses4% are found within the paranasal sinuses...
15
Malignant lesionsMalignant lesions
 Squamous cell carcinomaSquamous cell carcinoma
 Adenoid cystic carcinomaAdenoid c...
16
Squamous cell carcinomaSquamous cell carcinoma
 Most common tumor (80%)Most common tumor (80%)
 Location:Location:
 ...
17
TreatmentTreatment
 88% present in advanced stages (T3/T4)88% present in advanced stages (T3/T4)
 Surgical resection ...
18
Adenoid Cystic CarcinomaAdenoid Cystic Carcinoma
 33rdrd
most common site is the nose/paranasalmost common site is the...
19
Mucoepidermoid CarcinomaMucoepidermoid Carcinoma
 Extremely rareExtremely rare
 Widespread local invasion makes resec...
20
AdenocarcinomaAdenocarcinoma
 22ndnd
most common malignant tumor in themost common malignant tumor in the
maxillary an...
21
HemangiopericytomaHemangiopericytoma
 Pericytes of ZimmermanPericytes of Zimmerman
 Present as rubbery, pale/gray, we...
22
MelanomaMelanoma
 0.5- 1.5% of melanoma originates from the nasal0.5- 1.5% of melanoma originates from the nasal
cavit...
23
Olfactory NeuroblastomaOlfactory Neuroblastoma
EsthesioneuroblastomaEsthesioneuroblastoma
 Originate from stem cells o...
24
Olfactory NeuroblastomaOlfactory Neuroblastoma
EsthesioneuroblastomaEsthesioneuroblastoma
 UCLA Staging systemUCLA Sta...
25
Olfactory NeuroblastomaOlfactory Neuroblastoma
EsthesioneuroblastomaEsthesioneuroblastoma
 Aggressive behaviorAggressi...
26
SarcomasSarcomas
 Osteogenic SarcomaOsteogenic Sarcoma
 Most common primary malignancy of bone.Most common primary ma...
27
RhabdomyosarcomaRhabdomyosarcoma
 Most common paranasal sinus malignancy inMost common paranasal sinus malignancy in
c...
28
LymphomaLymphoma
 Non-Hodgkins typeNon-Hodgkins type
 Treatment is by radiation, with or withoutTreatment is by radia...
29
Sinonasal UndifferentiatedSinonasal Undifferentiated
CarcinomaCarcinoma
 Aggressive locally destructive lesionAggressi...
30
Metastatic TumorsMetastatic Tumors
 Renal cell carcinoma is the most commonRenal cell carcinoma is the most common
 P...
31
Staging of Maxillary Sinus TumorsStaging of Maxillary Sinus Tumors
www.indiandentalacademy.com
32
Staging of Maxillary Sinus TumorsStaging of Maxillary Sinus Tumors
 T1: limited to antral mucosa without bony erosionT...
33
SurgerySurgery
 Unresectable tumors:Unresectable tumors:
 Superior extension: frontal lobesSuperior extension: fronta...
34
SurgerySurgery
 Surgical approaches:Surgical approaches:
 EndoscopicEndoscopic
 Lateral rhinotomyLateral rhinotomy
...
35
TracheostomyTracheostomy
 130 maxillectomies only 7.7% required130 maxillectomies only 7.7% required
tracheostomytrach...
36
Treatment of the OrbitTreatment of the Orbit
 Before 1970’s orbital exenteration was includedBefore 1970’s orbital exe...
37
Current indications for orbitalCurrent indications for orbital
exenterationexenteration
 Involvement of the orbital ap...
38
ConclusionsConclusions
 Neoplasms of the nose and paranasal sinus areNeoplasms of the nose and paranasal sinus are
ver...
39
BibliographyBibliography
 Bhattacharyya N. Cancer of the Nasal Cavity: Survival and Factors Influencing Prognosis. Arc...
Thank youThank you
For more details please visitFor more details please visit
www.indiandentalacademy.comwww.indiandentala...
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Neoplasms of the nose and paranasal sinus /certified fixed orthodontic courses by Indian dental academy

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Dental Courses by Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
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Transcript of "Neoplasms of the nose and paranasal sinus /certified fixed orthodontic courses by Indian dental academy "

  1. 1. 1 Neoplasms of theNeoplasms of the Nose and ParanasalNose and Paranasal SinusSinusINDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. 2 Neoplasms of Nose and ParanasalNeoplasms of Nose and Paranasal SinusesSinuses  Very rare 3%Very rare 3%  Delay in diagnosis due to similarity to benignDelay in diagnosis due to similarity to benign conditionsconditions  Nasal cavityNasal cavity  ½ benign½ benign  ½ malignant½ malignant  Paranasal SinusesParanasal Sinuses  MalignantMalignant www.indiandentalacademy.com
  3. 3. 3 Neoplasms of Nose and ParanasalNeoplasms of Nose and Paranasal SinusesSinuses  Multimodality treatmentMultimodality treatment  Orbital PreservationOrbital Preservation  Minimally invasive surgical techniquesMinimally invasive surgical techniques www.indiandentalacademy.com
  4. 4. 4 EpidemiologyEpidemiology  Predominately of older malesPredominately of older males  Exposure:Exposure:  Wood, nickel-refining processesWood, nickel-refining processes  Industrial fumes, leather tanningIndustrial fumes, leather tanning  Cigarette and Alcohol consumptionCigarette and Alcohol consumption  No significant association has been shownNo significant association has been shown www.indiandentalacademy.com
  5. 5. 5 LocationLocation  Maxillary sinusMaxillary sinus  70%70%  Ethmoid sinusEthmoid sinus  20%20%  SphenoidSphenoid  3%3%  FrontalFrontal  1%1% www.indiandentalacademy.com
  6. 6. 6 PresentationPresentation  Oral symptoms: 25-35%Oral symptoms: 25-35%  Pain, trismus, alveolar ridge fullness, erosionPain, trismus, alveolar ridge fullness, erosion  Nasal findings: 50%Nasal findings: 50%  Obstruction, epistaxis, rhinorrheaObstruction, epistaxis, rhinorrhea  Ocular findings: 25%Ocular findings: 25%  Epiphora, diplopia, proptosisEpiphora, diplopia, proptosis  Facial signsFacial signs  Paresthesias, asymmetryParesthesias, asymmetry www.indiandentalacademy.com
  7. 7. 7 RadiographyRadiography  CTCT  Bony erosionBony erosion  Limitations with periorbita involvementLimitations with periorbita involvement  MRIMRI  94 -98% correlation with surgical findings94 -98% correlation with surgical findings  Inflammation/retained secretions: low T1, high T2Inflammation/retained secretions: low T1, high T2  Hypercellular malignancy: low/intermediate on bothHypercellular malignancy: low/intermediate on both  Enhancement with GadoliniumEnhancement with Gadolinium www.indiandentalacademy.com
  8. 8. 8 Benign LesionsBenign Lesions  PapillomasPapillomas  OsteomasOsteomas  Fibrous DysplasiaFibrous Dysplasia  Neurogenic tumorsNeurogenic tumors www.indiandentalacademy.com
  9. 9. 9 PapillomaPapilloma  Vestibular papillomasVestibular papillomas  Schneiderian papillomas derived fromSchneiderian papillomas derived from schneiderian mucosa (squamous)schneiderian mucosa (squamous)  Fungiform: 50%, nasal septumFungiform: 50%, nasal septum  Cylindrical: 3%, lateral wall/sinusesCylindrical: 3%, lateral wall/sinuses  Inverted: 47%, lateral wallInverted: 47%, lateral wall www.indiandentalacademy.com
  10. 10. 10 Inverted PapillomaInverted Papilloma  4% of sinonasal tumors4% of sinonasal tumors  Site of Origin: lateral nasal wallSite of Origin: lateral nasal wall  UnilateralUnilateral  Malignant degeneration in 2-13% (avg 10%)Malignant degeneration in 2-13% (avg 10%) www.indiandentalacademy.com
  11. 11. 11 Inverted PapillomaInverted Papilloma ResectionResection  Initially via transnasal resection:Initially via transnasal resection:  50-80% recurrence50-80% recurrence  Medial Maxillectomy via lateral rhinotomy:Medial Maxillectomy via lateral rhinotomy:  Gold StandardGold Standard  10-20%10-20%  Endoscopic medial maxillectomy:Endoscopic medial maxillectomy:  Key concepts:Key concepts:  Identify the origin of the papillomaIdentify the origin of the papilloma  Bony removal of this regionBony removal of this region  Recurrent lesions:Recurrent lesions:  Via medial maxillectomy vs. Endoscopic resectionVia medial maxillectomy vs. Endoscopic resection  22%22% www.indiandentalacademy.com
  12. 12. 12 OsteomasOsteomas  Benign slow growing tumors of mature boneBenign slow growing tumors of mature bone  Location:Location:  Frontal, ethmoids, maxillary sinusesFrontal, ethmoids, maxillary sinuses  When obstructing mucosal flow can lead toWhen obstructing mucosal flow can lead to mucocele formationmucocele formation  Treatment is local excisionTreatment is local excision www.indiandentalacademy.com
  13. 13. 13 Fibrous dysplasiaFibrous dysplasia  Dysplastic transformation of normal bone withDysplastic transformation of normal bone with collagen, fibroblasts, and osteoid materialcollagen, fibroblasts, and osteoid material  Monostotic vs PolyostoticMonostotic vs Polyostotic  Surgical excision for obstructing lesionsSurgical excision for obstructing lesions  Malignant transformation to rhabdomyosarcomaMalignant transformation to rhabdomyosarcoma has been seen with radiationhas been seen with radiation www.indiandentalacademy.com
  14. 14. 14 Neurogenic tumorsNeurogenic tumors  4% are found within the paranasal sinuses4% are found within the paranasal sinuses  SchwannomasSchwannomas  NeurofibromasNeurofibromas  Treatment via surgical resectionTreatment via surgical resection  Neurogenic Sarcomas are very aggressive andNeurogenic Sarcomas are very aggressive and require surgical excision with post oprequire surgical excision with post op chemo/XRT for residual disease.chemo/XRT for residual disease.  When associated with Von Recklinghausen’sWhen associated with Von Recklinghausen’s syndrome: more aggressive (30% 5yr survival).syndrome: more aggressive (30% 5yr survival). www.indiandentalacademy.com
  15. 15. 15 Malignant lesionsMalignant lesions  Squamous cell carcinomaSquamous cell carcinoma  Adenoid cystic carcinomaAdenoid cystic carcinoma  Mucoepidermoid carcinomaMucoepidermoid carcinoma  AdenocarcinomaAdenocarcinoma  HemangiopericytomaHemangiopericytoma  MelanomaMelanoma  Olfactory neuroblastomaOlfactory neuroblastoma  Osteogenic sarcoma, fibrosarcoma, chondrosarcoma,Osteogenic sarcoma, fibrosarcoma, chondrosarcoma, rhabdomyosarcomarhabdomyosarcoma  LymphomaLymphoma  Metastatic tumorsMetastatic tumors  Sinonasal undifferentiated carcinomaSinonasal undifferentiated carcinoma www.indiandentalacademy.com
  16. 16. 16 Squamous cell carcinomaSquamous cell carcinoma  Most common tumor (80%)Most common tumor (80%)  Location:Location:  Maxillary sinus (70%)Maxillary sinus (70%)  Nasal cavity (20%)Nasal cavity (20%)  90% have local invasion by presentation90% have local invasion by presentation  Lymphatic drainage:Lymphatic drainage:  First echelon: retropharyngeal nodesFirst echelon: retropharyngeal nodes  Second echelon: subdigastric nodesSecond echelon: subdigastric nodes www.indiandentalacademy.com
  17. 17. 17 TreatmentTreatment  88% present in advanced stages (T3/T4)88% present in advanced stages (T3/T4)  Surgical resection with postoperative radiationSurgical resection with postoperative radiation  Complex 3-D anatomy makes margins difficultComplex 3-D anatomy makes margins difficult www.indiandentalacademy.com
  18. 18. 18 Adenoid Cystic CarcinomaAdenoid Cystic Carcinoma  33rdrd most common site is the nose/paranasalmost common site is the nose/paranasal sinusessinuses  Perineural spreadPerineural spread  Anterograde and retrogradeAnterograde and retrograde  Despite aggressive surgical resection andDespite aggressive surgical resection and radiotherapy, most grow insidiously.radiotherapy, most grow insidiously.  Neck metastasis is rare and usually a sign of localNeck metastasis is rare and usually a sign of local failurefailure  Postoperative XRT is very importantPostoperative XRT is very important www.indiandentalacademy.com
  19. 19. 19 Mucoepidermoid CarcinomaMucoepidermoid Carcinoma  Extremely rareExtremely rare  Widespread local invasion makes resectionWidespread local invasion makes resection difficult, therefore radiation is often indicateddifficult, therefore radiation is often indicated www.indiandentalacademy.com
  20. 20. 20 AdenocarcinomaAdenocarcinoma  22ndnd most common malignant tumor in themost common malignant tumor in the maxillary and ethmoid sinusesmaxillary and ethmoid sinuses  Present most often in the superior portionsPresent most often in the superior portions  Strong association with occupational exposuresStrong association with occupational exposures  High grade: solid growth pattern with poorlyHigh grade: solid growth pattern with poorly defined margins. 30% present with metastasisdefined margins. 30% present with metastasis  Low grade: uniform and glandular with lessLow grade: uniform and glandular with less incidence of perineural invasion/metastasis.incidence of perineural invasion/metastasis. www.indiandentalacademy.com
  21. 21. 21 HemangiopericytomaHemangiopericytoma  Pericytes of ZimmermanPericytes of Zimmerman  Present as rubbery, pale/gray, well circumscribedPresent as rubbery, pale/gray, well circumscribed lesions resembling nasal polypslesions resembling nasal polyps  Treatment is surgical resection with postoperative XRTTreatment is surgical resection with postoperative XRT for positive marginsfor positive margins www.indiandentalacademy.com
  22. 22. 22 MelanomaMelanoma  0.5- 1.5% of melanoma originates from the nasal0.5- 1.5% of melanoma originates from the nasal cavity and paranasal sinus.cavity and paranasal sinus.  Anterior Septum: most common siteAnterior Septum: most common site  Treatment is wide local excision with/withoutTreatment is wide local excision with/without postoperative radiation therapypostoperative radiation therapy  END not recommendedEND not recommended  AFIP: Poor prognosisAFIP: Poor prognosis  5yr: 11%5yr: 11%  20yr: 0.5%20yr: 0.5% www.indiandentalacademy.com
  23. 23. 23 Olfactory NeuroblastomaOlfactory Neuroblastoma EsthesioneuroblastomaEsthesioneuroblastoma  Originate from stem cells of neural crest originOriginate from stem cells of neural crest origin that differentiate into olfactory sensory cells.that differentiate into olfactory sensory cells.  Kadish ClassificationKadish Classification  A: confined to nasal cavityA: confined to nasal cavity  B: involving the paranasal cavityB: involving the paranasal cavity  C: extending beyond these limitsC: extending beyond these limits www.indiandentalacademy.com
  24. 24. 24 Olfactory NeuroblastomaOlfactory Neuroblastoma EsthesioneuroblastomaEsthesioneuroblastoma  UCLA Staging systemUCLA Staging system  T1: Tumor involving nasal cavity and/or paranasalT1: Tumor involving nasal cavity and/or paranasal sinus, excluding the sphenoid and superior mostsinus, excluding the sphenoid and superior most ethmoidsethmoids  T2: Tumor involving the nasal cavity and/orT2: Tumor involving the nasal cavity and/or paranasal sinus including sphenoid/cribriform plateparanasal sinus including sphenoid/cribriform plate  T3: Tumor extending into the orbit or anteriorT3: Tumor extending into the orbit or anterior cranial fossacranial fossa  T4: Tumor involving the brainT4: Tumor involving the brain www.indiandentalacademy.com
  25. 25. 25 Olfactory NeuroblastomaOlfactory Neuroblastoma EsthesioneuroblastomaEsthesioneuroblastoma  Aggressive behaviorAggressive behavior  Local failure: 50-75%Local failure: 50-75%  Metastatic disease develops in 20-30%Metastatic disease develops in 20-30%  Treatment:Treatment:  En bloc surgical resection with postoperative XRTEn bloc surgical resection with postoperative XRT www.indiandentalacademy.com
  26. 26. 26 SarcomasSarcomas  Osteogenic SarcomaOsteogenic Sarcoma  Most common primary malignancy of bone.Most common primary malignancy of bone.  Mandible > MaxillaMandible > Maxilla  Sunray radiographic appearanceSunray radiographic appearance  FibrosarcomaFibrosarcoma  ChondrosarcomaChondrosarcoma www.indiandentalacademy.com
  27. 27. 27 RhabdomyosarcomaRhabdomyosarcoma  Most common paranasal sinus malignancy inMost common paranasal sinus malignancy in childrenchildren  Non-orbital, parameningealNon-orbital, parameningeal  Triple therapy is often necessaryTriple therapy is often necessary  Aggressive chemo/XRT has improved survivalAggressive chemo/XRT has improved survival from 51% to 81% in patients with cranial nervefrom 51% to 81% in patients with cranial nerve deficits/skull/intracranial involvement.deficits/skull/intracranial involvement.  Adults, Surgical resection with postoperativeAdults, Surgical resection with postoperative XRT for positive margins.XRT for positive margins. www.indiandentalacademy.com
  28. 28. 28 LymphomaLymphoma  Non-Hodgkins typeNon-Hodgkins type  Treatment is by radiation, with or withoutTreatment is by radiation, with or without chemotherapychemotherapy  Survival drops to 10% for recurrent lesionsSurvival drops to 10% for recurrent lesions www.indiandentalacademy.com
  29. 29. 29 Sinonasal UndifferentiatedSinonasal Undifferentiated CarcinomaCarcinoma  Aggressive locally destructive lesionAggressive locally destructive lesion  Dependent on pathological differentiation fromDependent on pathological differentiation from melanoma, lymphoma, and olfactorymelanoma, lymphoma, and olfactory neuroblastomaneuroblastoma  Preoperative chemotherapy and radiation mayPreoperative chemotherapy and radiation may offer improved survivaloffer improved survival www.indiandentalacademy.com
  30. 30. 30 Metastatic TumorsMetastatic Tumors  Renal cell carcinoma is the most commonRenal cell carcinoma is the most common  Palliative treatment onlyPalliative treatment only www.indiandentalacademy.com
  31. 31. 31 Staging of Maxillary Sinus TumorsStaging of Maxillary Sinus Tumors www.indiandentalacademy.com
  32. 32. 32 Staging of Maxillary Sinus TumorsStaging of Maxillary Sinus Tumors  T1: limited to antral mucosa without bony erosionT1: limited to antral mucosa without bony erosion  T2: erosion or destruction of the infrastructure,T2: erosion or destruction of the infrastructure, including the hard palate and/or middle meatusincluding the hard palate and/or middle meatus  T3: Tumor invades: skin of cheek, posterior wall ofT3: Tumor invades: skin of cheek, posterior wall of sinus, inferior or medial wall of orbit, anterior ethmoidsinus, inferior or medial wall of orbit, anterior ethmoid sinussinus  T4: tumor invades orbital contents and/or: cribriformT4: tumor invades orbital contents and/or: cribriform plate, post ethmoids or sphenoid, nasopharynx, softplate, post ethmoids or sphenoid, nasopharynx, soft palate, pterygopalatine or infratemporal fossa or base ofpalate, pterygopalatine or infratemporal fossa or base of skullskull www.indiandentalacademy.com
  33. 33. 33 SurgerySurgery  Unresectable tumors:Unresectable tumors:  Superior extension: frontal lobesSuperior extension: frontal lobes  Lateral extension: cavernous sinusLateral extension: cavernous sinus  Posterior extension: prevertebral fasciaPosterior extension: prevertebral fascia  Bilateral optic nerve involvementBilateral optic nerve involvement www.indiandentalacademy.com
  34. 34. 34 SurgerySurgery  Surgical approaches:Surgical approaches:  EndoscopicEndoscopic  Lateral rhinotomyLateral rhinotomy  Transoral/transpalatalTransoral/transpalatal  Midfacial deglovingMidfacial degloving  Weber-FergussonWeber-Fergusson  Combined craniofacial approachCombined craniofacial approach  Extent of resectionExtent of resection  Medial maxillectomyMedial maxillectomy  Inferior maxillectomyInferior maxillectomy  Total maxillectomyTotal maxillectomy www.indiandentalacademy.com
  35. 35. 35 TracheostomyTracheostomy  130 maxillectomies only 7.7% required130 maxillectomies only 7.7% required tracheostomytracheostomy  Of those not receiving tracheostomy duringOf those not receiving tracheostomy during surgery, only 0.9% experienced postoperativesurgery, only 0.9% experienced postoperative airway complicationsairway complications  Tracheostomy is unnecessary except in certainTracheostomy is unnecessary except in certain circumstances (bulky packing/flaps,circumstances (bulky packing/flaps, mandibulectomy)mandibulectomy) www.indiandentalacademy.com
  36. 36. 36 Treatment of the OrbitTreatment of the Orbit  Before 1970’s orbital exenteration was includedBefore 1970’s orbital exenteration was included in the radical resectionin the radical resection  Preoperative radiation reduced tumor load andPreoperative radiation reduced tumor load and allowed for orbital preservation with clearallowed for orbital preservation with clear surgical marginssurgical margins  Currently, the debate is centered on whatCurrently, the debate is centered on what “degree” of orbital invasion is allowed.“degree” of orbital invasion is allowed. www.indiandentalacademy.com
  37. 37. 37 Current indications for orbitalCurrent indications for orbital exenterationexenteration  Involvement of the orbital apexInvolvement of the orbital apex  Involvement of the extraocular musclesInvolvement of the extraocular muscles  Involvement of the bulbar conjunctiva or scleraInvolvement of the bulbar conjunctiva or sclera  Lid involvement beyond a reasonable hope forLid involvement beyond a reasonable hope for reconstructionreconstruction  Non-resectable full thickness invasion throughNon-resectable full thickness invasion through the periorbita into the retrobulbar fatthe periorbita into the retrobulbar fat www.indiandentalacademy.com
  38. 38. 38 ConclusionsConclusions  Neoplasms of the nose and paranasal sinus areNeoplasms of the nose and paranasal sinus are very rare and require a high index of suspicionvery rare and require a high index of suspicion for diagnosisfor diagnosis  Most lesions present in advanced states andMost lesions present in advanced states and require multimodality therapyrequire multimodality therapy www.indiandentalacademy.com
  39. 39. 39 BibliographyBibliography  Bhattacharyya N. Cancer of the Nasal Cavity: Survival and Factors Influencing Prognosis. Archives of Oto-Bhattacharyya N. Cancer of the Nasal Cavity: Survival and Factors Influencing Prognosis. Archives of Oto- HNS. Vol 128(9). September 2002. Pp 1079-1083.HNS. Vol 128(9). September 2002. Pp 1079-1083.  Bradley P, Jones N, Robertson I. Diagnosis and Management of Esthesioneuroblastoma. Current Opinion inBradley P, Jones N, Robertson I. Diagnosis and Management of Esthesioneuroblastoma. Current Opinion in Oto-HNS. Vol 11(2). April 2003. Pp 112-118.Oto-HNS. Vol 11(2). April 2003. Pp 112-118.  Carrau R, Segas J, Nuss D, et al. Squamous Cell Carcinoma of the Sinonasal Tract Invading the Orbit.Carrau R, Segas J, Nuss D, et al. Squamous Cell Carcinoma of the Sinonasal Tract Invading the Orbit. Laryngoscope. Vol 109 (2, part 1). February 1999. Pp 230-235.Laryngoscope. Vol 109 (2, part 1). February 1999. Pp 230-235.  Devaiah A, Larsen C, Tawfik O, et al. Esthesioneuroblastoma: Endoscopic Nasal and Anterior CraniotomyDevaiah A, Larsen C, Tawfik O, et al. Esthesioneuroblastoma: Endoscopic Nasal and Anterior Craniotomy Resection. Laryngoscope. Vol 113(12). December 2003. Pp2086-2090.Resection. Laryngoscope. Vol 113(12). December 2003. Pp2086-2090.  Han J, Smith T, Loehrl T, et al. An Evolution in the Management of Sinonasal Inverting Papilloma.Han J, Smith T, Loehrl T, et al. An Evolution in the Management of Sinonasal Inverting Papilloma. Laryngoscope. Vol 111(8). August 2001. Pp 1395-1400.Laryngoscope. Vol 111(8). August 2001. Pp 1395-1400.  Imola M, Schramm V. Orbital Preservation in Surgical Management of Sinonasal Malignancy. Laryngoscope.Imola M, Schramm V. Orbital Preservation in Surgical Management of Sinonasal Malignancy. Laryngoscope. Vol 112(8). August 2002. Pp 1357-1365.Vol 112(8). August 2002. Pp 1357-1365.  Katzenmeyer K, Pou A. Neoplasms of the Nose and Paranasal Sinus. Dr. Quinn’s Online Textbook ofKatzenmeyer K, Pou A. Neoplasms of the Nose and Paranasal Sinus. Dr. Quinn’s Online Textbook of Otolaryngology. June 7, 2000.Otolaryngology. June 7, 2000.  Kraft M, Simmen D, Kaufmann T, et al. Laryngoscope. Vol 113(9). September 2003. Pp 1541-1547.Kraft M, Simmen D, Kaufmann T, et al. Laryngoscope. Vol 113(9). September 2003. Pp 1541-1547.  McCary S, Levine P, Cantrell R. Preservation of the eye in the Treatment of Sinonasal Malignant NeoplasmsMcCary S, Levine P, Cantrell R. Preservation of the eye in the Treatment of Sinonasal Malignant Neoplasms with Orbital Involvement: A Confirmation of the Original Treatise. Archives of Oto-HNS. Vol 122(6). Junewith Orbital Involvement: A Confirmation of the Original Treatise. Archives of Oto-HNS. Vol 122(6). June 1996. Pp 657-659.1996. Pp 657-659.  Myers E, Suen J. Cancer of the Head and Neck, 3rd Edition: Neoplasms of the Nose and Paranasal Sinuses.Myers E, Suen J. Cancer of the Head and Neck, 3rd Edition: Neoplasms of the Nose and Paranasal Sinuses. W.B. Saunders Company. 1996.W.B. Saunders Company. 1996.  Myers L, Nussenbaum B, Bradford C, et al. Paranasal Sinus Malignancies: An 18-Year Single InstitutionMyers L, Nussenbaum B, Bradford C, et al. Paranasal Sinus Malignancies: An 18-Year Single Institution Experience. Laryngoscope. Vol 112(11). November 2002. Pp 1964-1969.Experience. Laryngoscope. Vol 112(11). November 2002. Pp 1964-1969. www.indiandentalacademy.com
  40. 40. Thank youThank you For more details please visitFor more details please visit www.indiandentalacademy.comwww.indiandentalacademy.com 40www.indiandentalacademy.com

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