Neoplasms of the Nasal Cavity & Paranasal Sinuses

4.8.1 Describe the clinical presentation and classification system for Juvenile Nasopharyngeal Angiofibroma (JNA).

4.8.2 Describe the surgical approaches for excision of JNAs and compare the advantages and disadvantages of each approach. What is the role of embolization in the management of JNA?

4.8.3 What is the differential diagnosis of benign sinonasal tumors?

4.8.4 What is the diagnosis of the pathology shown on these nasal endoscopic images? Discuss the differential diagnosis, etiology and long term history of this clinical entity.

http://portal.entnet.org/images/COCLIA/2011-2012%20updates/COCLIA%20Media/Neoplasms%20of%20the%20Nasal%20Cavity%20and%20Paranasal%20Sinuses/Neoplasms-of-Nasal-Cavity-Q4-081118_130.jpg

Mendenhall W, Hinerman R, Malyapa R, Werning J, Amdur R Villaret D Mendenhall N.Inverted papilloma of the nasal cavity and paranasal sinuses. Am J Clin Oncol 2007: 30(5): 560-563. PMID:17921720

Krouse JH. Development of a staging system for inverted papilloma. Laryngoscope. 2000 Jun;110(6):965-8. PMID:10852514

4.8.5 Describe the histopathology shown here. Discuss the surgical management options for the patient with this lesion.

http://portal.entnet.org/images/COCLIA/2011-2012%20updates/COCLIA%20Media/Neoplasms%20of%20the%20Nasal%20Cavity%20and%20Paranasal%20Sinuses/Neoplasms-of-Nasal-Cavity-Q5_081002_078.jpg

Melroy C, Senior B. Benign sinonasal neoplasms: a focus on inverting papilloma. Otolaryngol Clin North A; 2006, 39 (3):601-607. PMID:16757234

4.8.6 What is the differential diagnosis of malignant sinonasal tumors?

4.8.7 Describe the signs and symptoms of sinonasal tumors. Which of these are likely to be associated with malignant lesions?

4.8.8 Describe the role of CT and MRI imaging in the evaluation of sinonasal tumors. What is the typical appearance of tumor on T1 and T2 imaging? What impact does gadolinium enhancement have on the appearance of tumor?

4.8.9 Describe the known occupational risk factors associated with the development of sinonasal squamous cell carcinomas and adenocarcinomas.

4.8.10 Describe the AJCC staging system for sinonasal cancers.

4.8.11 Compare the indication, limitations and potential complications of the following surgical approaches to the nasal cavity and the paranasal sinuses: lateral rhinotomy, midface degloving, medial maxillectomy and total maxillectomy.

4.8.12 Is there a role for endoscopic surgical approaches to sinonasal tumors? What are the limits of an endoscopic surgical approach?

Hanna E, DeMonte F, Ibrhim S, Roberts,D Levine, N Kupferman M: Endoscopic Resection of Sinonasal Cancers with and without Craniotomy. Archoto 2009, 135: 1219-1224. PMID:20026819

4.8.13 Discuss other appropriate treatment modalities of sinonasal cancers.

4.8.14 What is a sinonasal undifferentiated carcinoma and how does it compare with an esthesioneuroblastoma?