The skull base, paranasal sinuses, and related malignancies

Tumors of the anterior skull base most commonly originate from the nasal cavity and paranasal sinuses. Such early presenting signs and symptoms as nasal obstruction, epiphora, and epistaxis are frequently thought to have a benign pathology. Proptosis, vision changes, skin fixation, and cervical adenopathy are associated with advanced disease. Treatment of paranasal sinus tumors is complex, involving combined therapy and multidisciplinary teams. The particular method of treatment is determined by multiple factors, including tumor histopathology, age, health of the patient, and extent of disease. In the past several years, numerous approaches to the skull base have evolved, allowing otolaryngologists and head and neck surgeons to extend earlier operative indications and treat cancers that were previously deemed unresectable. This article reviews some of the current surgical and nonsurgical approaches to skull base tumors originating from the paranasal sinuses.