The main treatment method for cases of sinus tumors is surgical removal. Treatment is simpler and more effective when the tumor is small, so early diagnosis is crucial. If left untreated, the tumor can become larger and more difficult and expensive to treat.
Overview of benign sinus tumors
Benign sinus tumors are abnormal growths of cells in the lining of the sinuses and adjacent cavities. Sinus and adjacent cavity tumors are rare, accounting for less than 3% of respiratory tract tumors.
The symptoms of sinus tumors are similar to those of chronic sinusitis, so they are often misdiagnosed. One characteristic that distinguishes sinus tumors from chronic sinusitis is that they usually occur on one side of the nose and can sometimes cause bleeding.
A definitive diagnosis of the nature of the tumor requires a histological examination.
In children, the majority of sinus and adjacent cavity tumors are benign. However, if not addressed in a timely manner, large tumors can lead to complications such as facial deformity and susceptibility to other respiratory diseases.
The main treatment method for cases of sinus tumors is surgical removal. Treatment is simpler and more effective when the tumor is small, so early diagnosis is crucial. If left untreated, the tumor can become larger and more difficult and expensive to treat.
Overview of benign sinus tumors
Two common types of benign nasal polyps
Nasal polyps
Nasal polyps are benign growths with soft stems, smooth surfaces, and light pink coloration. They are caused by local mucosal degeneration in the nasal sinuses and primarily consist of connective tissue.
The exact cause of nasal polyps is unknown, but they are often associated with certain conditions such as sinusitis, allergic rhinitis, and asthma.
Symptoms
Small nasal polyps may not cause any symptoms, but as they grow larger, they can cause difficulty breathing, nasal congestion, loss of smell, and increased susceptibility to respiratory infections. Changes in weather can also lead to a runny nose, pain in the sinus area, headaches, toothaches, itching around the eyes, and other symptoms.
During a nasal examination, the soft, smooth, and pink polyps can be seen. When polyps are present for a long time, they can form a cluster that fills the nasal cavity and can spread to the entire sinus cavity.
Treatment
Small nasal polyps can be treated with glucocorticoids, which reduce the activity of phospholipase A2 through lipocortin intermediates, thereby blocking the inflammation process, preventing the formation of prostaglandins and leukotrienes. This mechanism helps the medication affect all stages of inflammation in the tissue. The most common type of medication used is a nasal spray that has fewer side effects than oral medications.
If internal treatment is ineffective or the polyps are too large, surgery may be necessary. The type of surgery depends on the number and location of the polyps:
Polypectomy: A small mechanical instrument is used to suck out or cut the polyps in the nose or sinuses when the polyps are still small and solitary. After the procedure, a corticosteroid and antibiotic spray is used to prevent inflammation and infection.
Nasal endoscopy: This method helps the patient restore normal nasal airflow by using a thin, rigid endoscope with a camera inserted through the lower nasal passage. This approach removes the inflamed area while preserving the healthy mucous membrane, and the surgery is gentle, accurate, less painful, and heals quickly.
Pharyngeal fibroma
Pharyngeal fibroma is a benign tumor that develops in the posterior nasal cavity and pharyngeal vault, commonly found in adolescent males (13-18 years old). These fibrous tumors consist of fibrous cells with numerous strong fibers that have wide bases and are supplied by multiple blood vessels.
Causes
The exact cause of pharyngeal fibroma has not been determined, although evidence suggests a close relationship with endocrine factors. Puberty is a time of significant hormonal changes in the body, making this age group more susceptible to pharyngeal fibroma.
Other hypotheses suggest that the fibroma originates from bone osteogenesis disorder or chronic irritation of the mucous membrane due to chronic sinusitis.
Symptoms
Pharyngeal fibroma develops slowly and silently. Initial symptoms are nasal congestion on one side, similar to common respiratory diseases, and therefore, are often overlooked. The condition gradually worsens as the tumor grows, obstructing both nasal passages and causing excessive nasal discharge, leading to a constantly wet nasal cavity.
Initially, nosebleeds are infrequent and can be self-controlled. Over time, they become more frequent and severe, leading to chronic anemia.
Upon nasal examination, the tumor may completely fill the nasal cavity or partially obstruct the posterior or floor of the nasal cavity.
Upon posterior rhinoscopy, the tumor may be seen to fill the entire nasal cavity and extend into the pharyngeal vault.
The tumor has a smooth polyp-like appearance, but is firmer, whiter, and more opaque than a polyp.
Although pharyngeal fibroma is a benign tumor, if left untreated, it can lead to:
- Collapse of the maxilla.
- Erosion of the upper jawbone.
- Difficulty in chewing food.
- Protrusion of the eyeball or intracranial extension.
Treatment
The principle of treatment is surgical removal of the fibroma.
Surgery can be performed through various approaches, such as:
- The Denker’s approach.
- Rhinotomy or pharyngotomy.
- Surgery is necessary in cases of severe bleeding that requires blood transfusions.
- To prevent bleeding, ligation of the vessels should be performed before surgery.
Surgical removal must ensure complete excision of the fibrous base to prevent recurrence.
Although benign, you should have surgery.
Sinus Mucocele
Sinus mucocele is a benign type of tumor that is rarely encountered. It primarily affects adults. Although benign, if left untreated, the tumor can gradually erode and obliterate the bone, leading to deformities of the face and eyes.
The exact cause of the disease is still unknown, but factors believed to be related to the formation of sinus mucocele include obstruction of the nasal-sinus opening due to anatomical deformities or inflammation, prolonged use of antibiotics for sinusitis, trauma, or sinus surgery.
Clinical Symptoms
Sinus mucoceles located in the sinus cavity typically have no apparent symptoms.
The tumor has a relatively thick capsule and is filled with sterile, mucinous fluid that resembles raw egg whites or slightly yellowish in color.
Patients may experience headaches, although this is not typical.
Over time, sinus mucoceles can erode and obliterate the bone of the sinus cavity.
Early signs of a mucocele of the frontal sinus include swelling and bulging in the corner of the eye socket, followed by swelling of the entire outside of the sinus. The eyes may appear bulging or sunken, and the eyelids may droop, possibly affecting vision.
If the tumor grows large, it can cause deformities of the facial skeleton.
Diagnosis
X-rays reveal a radiopaque mass containing mucin and fat cells. The sinus wall is thin, sharply defined, and widely infiltrating in all directions, and areas of bone destruction may be visible.
Aspiration of the fluid from the mucocele that has obliterated the sinus cavity reveals sterile, mucinous fluid that resembles raw egg whites or slightly yellowish in color and has no foul odor.
Bacterial culture is negative.
Treatment
The treatment for ethmoid sinus mucocele is surgical removal of the mucocele.
A wide drainage passage of the sinus must be created to prevent recurrence.
For mucoceles in the frontal sinus, further examination by an ophthalmologist is necessary if there are symptoms in the eye.
Aspiration should only be done prior to surgery to avoid infection.
Bone tumor
Bone tumor is a benign tumor located in the maxillary or frontal sinus. It is more common in young people. [6]
The cause of the disease is still unclear.
Clinical symptoms
The tumor forms silently with almost no symptoms, gradually developing along the concentric layers of bone.
As the tumor grows, it can cause:
Blockage of the sinus opening, resulting in retention of secretions and headache.
Compression of the nasal cavity causing nasal obstruction.
Development of inflammation in the sinus mucosa, causing swelling, irritation or bleeding.
Deformation of the affected area of the face.
Compression of the eye socket causing tearing and protrusion of the eyeball.
Diagnosis
X-rays in three positions, Blondeau, Hirtz and oblique skull views, are used to determine the location and extent of the tumor.
CT scans provide clearer images.
Treatment
Surgical removal of the tumor using an electric drill.
Caution should be taken to avoid damaging the sinus wall and minimize the risk of tumor recurrence.
Tooth odontoma
Tooth odontoma is a common type of tumor in the upper jaw bone that protrudes deep into the maxillary sinus. It is called a tooth odontoma because the tumor contains a tooth formed from the remaining Malasez epithelium fragment in the jaw bone.
Symptoms
At the beginning of the disease, there are no noticeable symptoms.
As the tumor grows, it causes swelling on the outer surface of the canine fossa, which feels hard but not painful.
The disease progresses slowly, but if left untreated, it can erode and thin the bone.
In the case of a tooth odontoma in the canine fossa area, the front surface of the maxillary sinus is swollen, deforming the face, and feels bumpy like a ping pong ball.
In the case of a tooth odontoma in the upper jaw area, the gums and tooth roots are swollen, bumpy, and can cause tooth decay.
In the case of a tooth odontoma in the floor of the nasal cavity, it can cause deformation but without pain, fever, or inflammation.
An X-ray can show the tumor image eating into the maxillary sinus, causing it to expand on one side. It may even show a complete tooth attached to the bone.
Treatment
Tooth odontoma is treated by surgically removing the entire tumor.
If the tumor has invaded the maxillary sinus, it is necessary to create a hole in the nasal cavity and close the incision.
Nasal floor cysts
Nasal floor cysts are benign tumors located in the nasal floor (nasal cysts). [7]
Symptoms
The growth of the tumor in the nose usually does not present any special signs, and the patient only accidentally discovers it when they visit an ear, nose, and throat doctor.
When the cyst becomes larger, there is a feeling of fullness on one side of the nose, sometimes leading to stuffiness, and the area of the nasal floor may appear slightly swollen at the entrance of the nose. Pressing on the swollen area gives a soft and spongy feeling.
Aspirating the cyst reveals a sticky, viscous fluid.
Treatment
The cyst is removed through surgery following the vein groove of the lip.
To prevent the cyst from re-growing, complete removal of its lining is necessary.
Nasal Hemangioma
Nasal hemangioma is a common type of tumor in children, originating from the nasal septum or turbinates.
Symptoms
Bleeding from one nostril.
Endoscopy shows a smooth, dark-colored (ripe grape color) round mass.
Gentle palpation of the mass reveals its softness; strong pressure can cause bleeding.
Treatment
Small tumors can be treated with cauterization.
Large tumors require ligation and excision.
It is important to prevent blood from flowing down the posterior nasal cavity into the pharynx and to completely remove the hemangioma to prevent recurrence.
Johnny Jacks was born in 1985 in Texas, USA. He is the founder of Good Health Plan and is passionate about helping people improve their health and physical well-being. With over a decade of experience working in the healthcare industry, he currently works at Goodheathplan.com – a blog that shares knowledge on beauty and health.