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Paranasal Sinus and Nasal Cavity Cancer

Diagnosis

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The diagnosis of paranasal sinus and nasal cavity cancer can be made through the following methods:

  • Medical history and physical examination: Paranasal sinus and nasal cavity cancer affect various organs, such as the eyes and nose, and the patients usually present with multiple symptoms. The patients undergo comprehensive health evaluation to determine the cause of the symptoms. They are asked about the occurrence, duration, and progression of the symptoms to determine the course of the disease. The patients are also asked about smoking or if they work or live in an environment with an increased risk of secondhand smoke as it increases the risk of paranasal sinus and nasal cavity cancer. Further, the occupational background of the patients is also checked, as prolonged exposure to certain toxic chemicals, such as formaldehyde, wood dust, nickel, and chromium, increases the risk of paranasal sinus and nasal cavity cancer. The medical history of the patients is also inquired, as human papillomavirus infection also increases paranasal sinus and nasal cavity cancer risk.
  • Blood tests: Blood tests are not specifically used to detect paranasal sinus and nasal cavity cancer. However, these tests provide valuable information about the overall health of the body and the activity of organs, such as the lungs, liver, and kidneys. In addition, these tests help to determine if cancer has spread to these organs.
  • Further, blood tests are used before the initiation of treatment in patients with a confirmed diagnosis of paranasal sinus and nasal cavity cancer. Blood tests include CBC, liver function tests, kidney function tests, electrolytes, and blood gas analyses.
  • Nasal endoscopy: Nasal endoscopy is performed to closely examine the tissues of the nasal cavity and throat. The procedure is done through an endoscope, a thin, long tube with a video camera at the tip. The endoscope is inserted into the nose and guided to the throat. The images of the internal structures are relayed on the computer. The procedure is usually conducted under local anesthesia. Once the nasal endoscopy is completed, the patients are advised not to eat or drink for at least one hour.
  • CT scan: CT scan uses X-rays to create detailed 3D images of the paranasal sinus and nasal cavity, including the bones, tissues, and blood vessels. It helps in detecting paranasal sinus and nasal cavity cancer. Further, it also provides information about the spread of the tumor to the bones surrounding the paranasal sinuses or at the skull base. Patients are also recommended to undergo a CT scan to determine the spread of the tumor to other sites, such as lymph nodes or lungs.
  • X-ray: X-rays are less commonly used for evaluating paranasal sinus and nasal cavity cancer because of clearer and more detailed images provided by the CT scan. If used, an X-ray detects the spread of the tumor to the lungs. It also provides information about the infection or blockage in the sinuses.
  • MRI: It uses strong magnetic forces and radio waves to create detailed images of the bones, organs, tissues, and blood vessels. These images can be viewed on the computer. It provides detailed information about the presence of the tumor and its spread to the localized areas, such as bones surrounding the sinus and skull base, as well as distant sites, such as the covering of the brain, lungs, liver, and lymph nodes. In some cases, MRI assists the oncologists in differentiating between non-cancerous and cancerous tumors on the paranasal sinus and nasal cavity.
  • PET scan: This technique uses a radioactive sugar derivative as an energy source, especially for cancer cells. When the radioactive sugar is injected into the blood vessels, it reaches the cancer cells through blood circulation. A specialized tracer device is used to detect the accumulation of radioactive sugar by scanning the whole body. PET scan helps determine the spread of paranasal sinus and nasal cavity cancer throughout the body.
  • Biopsy: It involves taking samples of abnormal cells from the paranasal sinuses, nasal cavities, and other organs (suspected to have cancer) and sending them to the laboratory to determine the presence of cancer cells. There are various types of biopsy methods. An endoscopic biopsy is performed when the nasal cavity is evaluated with an endoscope. Fine needle aspiration is done when a small sample is required for the nasal cavity, paranasal sinuses, and lymph nodes. When a large sample is required or endoscopic and fine needle aspiration is not feasible, a biopsy is performed through surgical interventions.

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