Thyroid & Adrenal
Treatment for squamous cell carcinoma of maxilla stage III is
|C||Surgery + Chemotherapy|
|D||Surgery + Radiotherapy|
a. The standard treatment for malignant tumors of the paranasal sinuses is surgical resection and, in most cases, postoperative adjuvant radiation therapy. The extent of surgery is determined by the preoperative evaluation of disease spread.
b. Tumors arising along the medial wall of the maxillary sinus may be treated by means of a medial maxillectomy .
c. The treatment of advanced tumors of the paranasal sinuses frequently involves a multispecialty approach.
d. For vascular tumors, preoperative embolization is frequently necessary to reduce intraoperative hemorrhage. The embolization is ideally performed within 24 hours of the planned surgical resection.
e. When craniofacial resection is necessary for intracranial spread, cerebrospinal fluid decompression is performed through a lumbar drain.
f. The prognosis for these patients depends on tumor location and extension to the adjacent sinuses, orbit, and intracranial cavity.
g. Infrastructure maxillectomy, which includes removal of the hard palate and the lower maxillary sinus, is necessary for inferiorly based tumors of the maxillary sinus .
h. For tumors in the upper portion of the maxillary sinus, complete maxillectomy (including removal of the orbital floor) is performed.
i. If erosion of the cribriform has occurred, an anterior craniofacial resection is the standard approach.
j. The neurosurgeon performs a frontal craniotomy for exposure of the anterior cranial fossa floor, whereas the head and neck surgeon proceeds through a transfacial approach to resect the inferior bony attachments.
k. Paranasal sinus malignancies that are deemed unresectable are those with bilateral optic nerve involvement, massive brain invasion, or carotid encasement.
l. The goals of rehabilitation are to provide facial contour and separation of the oral cavity–oropharynx from the nasopharynx, which facilitates speech and swallowing.
m. Combined treatment with surgery and postoperative radiotherapy for squamous cell carcinoma of the sinuses consistently has been shown to provide survival superior to either radiation or surgery alone.
n. Rhabdomyosarcoma is treated with chemotherapy followed by radiation therapy and surgery is reserved for persistent disease after chemoradiation.
o. undifferentiated carcinoma is highly aggressive and is not frequently controlled with standard therapy.
p. Chemotherapy may help to reduce the tumor bulk and allow for orbital preservation.