Best Maxillary Sinus Tumour Surgery in India

Maxillary sinus tumours are considerably rare and implicated in less than 1% of all malignancies. Carcinomas such as squamous cell cancer, adenoid cystic carcinoma, head-and-neck cancer, lymphoma, sarcoma, adenocarcinoma, and mucoepidermoid carcinoma are all histologic forms of maxillary sinus cancer. Males are more susceptible to developing maxillary sinus tumour than females. These tumours are typically classified based on the part that is affected, and as such, we may have facial, auditory, ocular, oral, and nasal tumours.

Maxillary sinus malignancies are asymptomatic at the early stage and are mostly discovered when they are already in the advanced stage. This, coupled with the fact that the nasal cavity and paranasal sinuses are close to the brain, carotid artery, orbit, and skull base makes it difficult to manage maxillary sinus tumours. The treatment and/or management of these tumours normally involve(s) experts – oculoplastic surgeons, throat surgeons, ophthalmologists, ENT surgeons, neurosurgeons, surgical oncologists, and radiotherapists – across various medical fields.

Stages of Maxillary Sinus Malignancies

The stages of maxillary sinus malignancy reflect the size of the tumour, as well as how advanced the cancer is. Five stages of this tumour have been identified and discussed as follows:

• Stage 0: This is the very early stage of maxillary sinus malignancy, and it is usually minimally invasive – with only the top layer of the cell lining the maxillary sinus affected. Leaving this untreated can, however, result in devastating consequences.
• Stage 1: In this case, the tumour has grown deep into the mucosal lining of the maxillary sinus.
• Stage 2: This defines the onset of the tumour growing into the bone around the maxillary sinus, but does not grow into the bone at the back of the maxillary sinus.
• Stage 3: As stage 3 maxillary sinus malignancy is concerned; the growth has extended into the posterior wall, the underlying tissues, bottom/side of the eye socket, or into the ethmoid sinus. Also, the tumour may be found in one of the lymph nodes on the side of the neck.
• Stage 4: Maxillary sinus malignancies at stage 4 are advanced irrespective of whether or not they have spread into the lymph nodes and/or other parts of the body. Stage 4 maxillary sinus malignancy has 3 subtypes, namely:
  • Stage 4a: In this case, the tumour growth has proliferated to the skin of the cheek, sphenoid sinus, frontal part of the eye socket, cribriform plate, pterygoid plates, frontal sinus, or infratemporal fossa. The tumour can also appear in one lymph node at the neck side. The node, with the tumour, may measure 6cm or less.
  • Stage 4b: Stage 4b is characterized by maxillary sinus tumours that have grown into one or more lymph nodes and even outside them (that is, the nodes), with one of such nodes having a measurement that exceeds 6cm. Stage 4b tumour growth can extend into the space between the posterior of the nose and the nasopharynx, the brain, tissue layer covering the brain, posterior of the eye socket, some portions of the skull base, or cranial nerves.

Stage 4c: This is the last stage, and it is defined by the spread of the malignancy to the brain, liver, or lungs. The lymph node may also be affected.     

Predisposing Factors

• Smoking
• History of chronic sinusitis
• Prolonged exposure to chemicals and air pollutants like formaldehyde, rubbing alcohol, wood dust, chromium, nickel, and glue fumes.

Symptoms

The signs and symptoms of the presence of tumours of the maxillary sinus include:

• Lump localized in the roof of the mouth or on the face
• Sore in the nose
• Facial numbness
• Double vision
• Blockage in the sinuses
• Runny nose
• Bleeding from the nose
• Chronic headache
• Pain in the upper teeth

Diagnosis

The physician will initially examine the patient physically to see if any symptoms indicate the development of a maxillary sinus tumour. A sinus endoscopy is done to allow the physician to see the defective tissue that is present around the sinuses. Thereafter, he/she will proceed to carry out some diagnostic imaging tests – computed tomography, magnetic resonance imaging, positron emission tomography, and X-ray – on you to obtain scans of the affected areas. To gain comprehensive details of the abnormal tissue that is found in the sinuses, the specialist will conduct a biopsy by removing a small portion of the tissue and run certain tests in the laboratory – this should confirm whether the tissue is cancerous or not.

Based on the report from the diagnostic examinations; the physician will seek to choose the best maxillary sinus tumour treatment routine for you, and will extensively discuss this with you. Again, the surgeon may ask for your treatment preference.  

Treatment of Maxillary Sinus Tumour in India

There are both surgical and non-surgical means of managing maxillary sinus tumour. The two forms of therapeutic interventions can be combined to achieve a far-reaching positive outcome. Some treatment regimens for maxillary sinus tumours include:

• Radiation therapy: Here, the goal is to use radiation generated from high-energy x-rays to destroy the tumours. Radiation therapy can be given through implants – this is known as brachytherapy – that are placed around the tumour as the patient is hospitalized. Another technique used for applying radiation is through external-beam therapy; this involves the use of a machine to deliver the radiation from outside the body. It has to be stressed that while radiation therapy can be used alone in certain cases, there may be a need to use it along with either surgery or chemotherapy in other instances. That said, there are a few complications that are associated with radiation; some of these include tooth decay, fatigue, nausea, sores in the throat and mouth, dry mouth, loss of appetite, loss of sense of taste, etc.
• Chemotherapy: In this regard, chemotherapeutic medications are orally or intravenously administered to destroy the tumours. It is aimed at stopping the further multiplication and/or spread of the tumour and may either be given along with surgery or radiation. Some of the complications that may amount from employing chemotherapeutic intervention in the management of maxillary sinus tumour include nausea, fatigue, vomiting, loss of hair, diarrhoea, infection, loss of appetite.

Surgical Treatment: Maxillectomy

Maxillectomy involves the removal of one or all the part(s) of the upper jawbone. As a result of this, we can have partial maxillectomy, total maxillectomy, and radical maxillectomy. Partial maxillectomy entails the removal of one or more – but not all – bony wall(s) of the upper jawbone while total maxillectomy has to do with the removal of all (four) walls of the upper jawbone. However, in radical maxillectomy, all the bony walls are removed along with some surrounding structures.

Maxillectomy is usually performed under general anaesthesia, and the surgeon will move in to make an incision along the side of the patient’s nose down to the upper lip – this is after the effect of the anaesthesia has set in. In order to prevent the creation of a conspicuous scar on the face, the surgeon will make a cut under the upper lip on the inside, and then gains access to the upper jawbone, and removes the bony wall(s) accordingly. Radiation therapy or chemotherapy may also be applied here. The space that is now emergent due to the removal of the bone can then be filled with a prosthesis that is in the mould of the patient’s denture plate – this is where the prosthodontist comes in.

You should understand the procedure (maxillectomy) so described here is only suitable for Stage 1 and Stage 2 maxillary sinus malignancies, a surgical procedure known as neck dissection will be required for the management of malignancies that are in the advanced stages – 3 and 4. This is of particular importance due to the need to remove the tumour from the lymph nodes.

Maxillectomy also has its side effects, and these may include impairment of smell and taste, chewing and swallowing difficulties, watery eyes, and speech impediment.

Post-Treatment Considerations

The treatment – or more appropriately, management – of maxillary sinus tumour is a continual process. As such, you will need to be committed to your recovery – using your medications and keeping to the instructions that the specialists have given you. By the way, your physician or surgeon should design a maxillary sinus tumour treatment course for you. Concerning the swelling that will most likely occur after maxillectomy; you should regularly apply cold packs to reduce it.

Have Your Maxillary Sinus Tumour Removed at The Esthetic Clinics

You can have your maxillary sinus tumour treatment in Mumbai at The Esthetic Clinics. You do not need to look far away; our highly professional medical team is very much up to the task. We understand what it entails to perform a treatment/management that relates to a structure as complicated as the maxillary sinus, and will work with your personal physician to design a fitting treatment regimen for you. India’s most celebrated oculoplastic surgeon, Dr. Debraj Shome is also with us to provide hands-on expertise that will bring the most satisfactory outcome.

Cost of Treating Maxillary Sinus Tumour in India

The cost of maxillary sinus tumour treatment will be largely determined by the size and stage of the maxillary sinus malignancy, which would ultimately influence the kind of treatment that would be selected. You can fix an appointment with The Esthetic Clinics today to have your condition assessed and then get the exact price for maxillary sinus tumour treatment as it pertains to you.