LV Carcinoma of the Accessory Nasal Sinuses

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Abstract
Treatment of carcinoma of the accessory sinuses is discussed. It is thought that tumors of the nose and accessory sinuses can be divided, depending upon site of origin into nasal, ethmoidal and antral tumors. It appears that the classification of Setieleau into supra- and infra-structures divided by the middle turbinate is the most useful and reliable guide to prognosis. Those arising above this middle turbinate have a much poorer prognosis than those arising below the middle turbinate. Treatment of malignant disease of the nose and accessory sinuses does not differ according to site. The combination of radiotherapy and surgery is the treatment of choice. The area is irradiated on a broad base with a full cancerocidal dose of approxi?mately 5 or 6000 r. Six weeks after a thorough surgical debridement is carried out along with the removal of the hard palate. Occasionally involvement of the eye may result in an orbiltal exenteration, but fol?lowing radiotherapy this did not seem to be as commonly necessary as it was prior to the use of radiotherapy combined with subsequent surgery. The removal of the palate is mandatory, and no attempt at closure should be made until we are satisfied that recurrence of the tumor is unlikely. The deficiencies caused by the surgical procedures can readily be corrected by proper prostheses, and they should not deter the surgeon from carrying out an adequate excision.

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