Chronic sinusitis in head and neck cancer patients who received radiotherapy or chemoradiotherapy

The aim of this study was to evaluate the status of paranasal sinus and to identify risk factors associated with the development of chronic sinusitis based on imaging studies in head and neck cancer patients.

We retrospectively analyzed the medical records of 186 patients who were diagnosed with head and neck squamous cell carcinoma at Korea University Guro Hospital from February 2003 to July 2015. Only patients with at least 1 year of follow-up after treatment were included.

Chronic sinusitis occurred in 32 patients (17.2%), including seven patients (16.3%) in non-radiotherapy group and 25 patients (17.5%) in radiotherapy group. Maxillary sinus was most commonly involved (56.9%), followed by ethmoid, frontal, and sphenoid sinuses. Age (1.006; 0.874-1.158; p = 0.936), TNM stage (0.104; 0.007-1.598; p = 0.105), and underlying disease (0.242; 0.036-1.646; p = 0.147) were not significantly associated with the need for surgery due to sinusitis. Although radiotherapy itself (1.319; 0.019-2.821; p = 0.251) was not significantly associated with surgery due to sinusitis, concurrent chemotherapy (10.729; 1.361-84.611; p = 0.024) was significantly associated with surgical procedures.

Higher T stage and concurrent chemotherapy with radiotherapy showed significant association with chronic sinusitis. Concurrent chemotherapy also showed significant association with surgical treatment in head and neck cancer patients. Therefore, more careful surveillance and aggressive treatment of chronic sinusitis is needed in head and neck cancer patients who receive radiotherapy with concurrent chemotherapy or higher T stage.