The exact treatment depends on the location and severity of the cancer. Sinus surgery, chemotherapy, and radiation for head and neck cancers are used to remove the cancer and help prevent recurrence.
Nasal Cavity Cancer Surgery
Nasal cavity cancers are usually removed by a wide local excision. A wide local excision includes the area around the tumor to assure all cancer cells are removed:
- Nasal septum. If the tumor involves the dividing wall of the nasal cavity (the nasal septum) either a portion or the entire septum is removed.
- Nasal cavity. If the tumor is growing on the side wall of the nasal cavity, the wall must be removed. Sometimes the surgeon can remove the tumor by cutting under the upper lip so visible incisions are not needed. If this is not possible, the surgeon will cut through the skin on the side of the nose. Then the skin and nose are folded back to remove the tumor.
- If the cancer has grown into the tissue, part of the nose or the entire nose might need to be removed. A reconstructive surgeon rebuilds the nose with the surrounding facial tissues or from artificial materials (prosthesis).
Paranasal Sinus Surgery
- Ethmoid sinuses. If the tumor is very small, and is located within the ethmoid sinuses only, the surgeon can remove the tumor through the nostril with an endoscope (a thin lighted tube). If the tumor is much larger, an incision on the side of the nose may be necessary.
- Maxillary sinus. If the tumor involves the maxillary sinus, a maxillectomy is needed. The type of maxillectomy depends on the exact location of the tumor. If the tumor is small and toward the middle of the sinus, the surgeon can remove the tumor through the nostril with an endoscope. If the tumor is larger, the surgeon will make the incision along the side of the nose or under the upper lip. The surgeon might need to remove bone from the hard palate, the upper teeth on one side of the mouth, part or all of the orbit (eye socket), part of the cheekbone, and/or the bony part of the upper nose.
A craniofacial resection may be needed if the cancer involves the ethmoid sinuses, frontal sinuses, and the sphenoid sinuses. A craniofacial resection requires both a head and neck surgeon and a neurosurgeon. If the tumor is located in the roof the nasal cavity, and invades into the brain, surgeons will need to remove the tumor from the nose and the brain.
Endoscopic surgery is less destructive to normal tissue than conventional operations. The surgeon inserts a thin lighted tube (endoscope) into the nasal cavity, or sinus, instead of opening the area with an incision. The image is enlarged on a computer screen. Small (micro) instruments are used with the endoscope.
Surgeons are using the endoscopic method increasingly more often for treatment of nasal tumors, ethmoid tumors, and for nasal cavity cancer.
Radiation treatments are usually needed after surgery.
If cancer has affected the lymph nodes in the neck, a neck dissection (removal of the lymph nodes) might be needed during any type of head and neck cancer surgery.
Radiation therapy stops cancer cells from dividing. The growth of the tumor is slowed. Radiotherapy also destroys cancer cells and can shrink or eliminate tumors.
Chemotherapy is prescribed for different reasons:
- Together with radiotherapy as an alternative to surgery (called chemoradiation)
- After surgery to decrease the risk of the cancer returning
- To slow the growth of a tumor and control symptoms when the cancer cannot be cured (palliative treatment)
- The combination of surgery, radiation or chemotherapy depends on the size, the location and the type of tumor