Malignant sinonasal tumours: the Dublin Eye and Ear Hospital experience

We identified 51 patients from pathology and operative records who were treated in the Royal Victoria Eye and Ear Hospital with malignant sinonasal tumours between January 1980 and December 1991. Complete follow up was available in 43 patients. There were 30 males, mean age 50 years, range (10-80) and 13 females, mean age 59 years, range (34-75). Commonest presentations were nasal obstruction, nasal discharge and facial swelling. Patients presented late because of initial non specific symptoms. The maxilla was the site of origin in 18 patients, the ethmoids in 13 patients and the nasal cavity in 12 patients. There was a wide range of histological types with squamous cell carcinoma occurring in 19 patients (44%). All patients were treated with surgery, radiotherapy or a combination of both. Chemotherapy was used as an adjunctive therapy in three patients. Local recurrence occurred in 21 (50%) of the patients. Overall three year survival was 58% and five year survival was 45%. These figures compare favourably with larger series in the literature. A high index of suspicion, early recognition and referral of these patients is required to improve survival.