Cancers involving maxillary sinus are rather uncommon. Incidence ranges
between 0.5-1% of all malignancies. It constitutes about 3% of all
head and neck malignancies.
infections – EB virus, and Human papilloma virus infections
to wood dust – Especially African Mahogany wood dust causes
adenocarcinoma of maxillary sinus
working in nickel and chrome industries are more prone to develop
cancer of maxillary sinus
working in leather industries are also known to develop cancer of
causes – Post irradiation
of snuff have also been documented to
be the causative factor
Commonest type of malignancy involving the maxillar sinus is squamous cell
carcinoma about 80%. The second commonest tumor involving the
maxillar sinus is adenocarcinoma.
The following are the various types of malignant tumors of maxillary
Face – Swelling of the cheek. Pain and paresthesia over the cheek.
Orbital – Proptosis, diplopia, loss of vision
Nasal – Nasal deformity, unilateral nasal obstruction, blood tinged nasal
discharge, epistaxis, hyposima (rare)
Neurological – Multiple cranial nerve paralysis
Oral – Loosening of teeth, ill fitting dentures, swelling involving
palate, trismus (due to involvement of pterygoid muscles)
Otological symptoms – Ear block due to eustachean tube involvement, referred
Cervical symptoms – Cervical nodal metastasis
Involvement of anterolateral wall of maxilla present as:
nerve paresthesia / anesthesia
of inferior wall of maxilla present as:
over buccogingival sulcus
of upper dentition
is seen in patients with involvement of pterygoid muscles
of floor of orbit present as:
of ocular movement
thickening over orbital rim
of medial wall presents as:
inside nasal cavity
endoscopy – If there is involvement of medial wall of maxilla the
mass could be seen to present itself inside the nasal cavity. If
the mass could be seen within the nasal cavity biopsy can be taken
from the lesion. Under
endoscopic vision inferior meatal antrostomy can be performed and
the interior of the maxillary sinus can be examined and biopsy can
be taken from the lesion.
ray paranasal sinuses water's view – shows opacity with expansion
of the involved maxillary sinus. Erosion of the floor /
anterolateral wall of the orbit can also be seen if present
scan paranasal sinuses – Shows the extent of lesion, involvement
of adjacent areas, evidence of bone erosion if present
imaging shows better soft tissue delineation. Extension into
pterygopalatine fossa can be clearly seen
from the lesion is virtually diagnostic.
optimal management modality depends on the extent of tumor and the
the tumor is confined to the inferior portion of the maxilla the
condition is best managed by partial maxillectomy followed by
involving the whole of the maxilla can be managed by total
maxillectomy followed by irradiation.
of orbit can be managed by combining orbital exenteration along with
of maxilla extending to infratemporal fossa can be managed by
extended maxillectomy using Barbosa technique. Maxillectomy is
combined with condylectomy and resection of pterygoid plate and
muscles attached to it.
dissection can be resorted to if neck nodes are involved.
given by using Telecobalt or linear accelerator. Dosage include 6500
rads in divided fractions over 5 weeks. It is usually administered 5
days a week.
and 5flurouracil can be administered along with radiotherapy. This
is preferred in advanced cases of malignancy involving the maxillary