Staging of Sinonasal and Ventral Skull Base Malignancies

MR imaging of Nasal and Paranasal Sinus Malignant Neoplasms

MRI is useful for evaluating sinonasal malignancies. In particular, MRI can provide important information pertinent to treatment planning, such as delineating the presence of intracranial and orbital extension. This article reviews the MRI protocols, staging, imaging features, and differential diagnosis related to malignant nasal and paranasal sinus neoplasms.

Posttreatment Magnetic Resonance Imaging Surveillance of Head and Neck Cancers

Treatment strategies and recommended surveillance imaging differ for head and neck cancers depending on subsite and neoplasm type, and pose confusion for referring physicians and interpreting radiologists. The superior soft tissue resolution offered by magnetic resonance imaging is most useful in the surveillance of cancers with high propensities for intraorbital, intracranial, or perineural disease spread, which most commonly include those arising from the sinonasal cavities, nasopharynx, orbits, salivary glands, and the skin. This article discusses recommended surveillance protocoling and reviews treatment approaches, common posttreatment changes, and pearls for identifying disease recurrence in a subsite-based approach.

[Tumors of the paranasal sinus invading the orbit]

Invasion of the orbit by tumors of the paranasal sinus represents an advanced state of disease. Prognosis has hardly improved in recent decades, despite multimodal therapeutic approaches. Complete resection of the tumor still remains the most promising therapy. Orbital exenteration implies a dramatic event for the patient's psyche and quality of life. If the eye that would have to be exenterated is the only one remaining with sufficient vision, exenteration should be abandoned in consensus with the patient. Aesthetic improvements following exenteration can be achieved by surgical and prosthetic techniques. The method of prosthesis fixation needs to be determined with respect to the patients' individual expectations and manual abilities. The main aspects of functional rehabilitation are good local cleanability and sufficient nasal breathing without encrusted mucus, which can be achieved by restoring the natural laminar airflow. Tumors of the paranasal sinus with orbital invasion represent a diagnostic and therapeutic challenge. The information regarding prognosis, therapeutic approaches, post-therapeutic quality of life, and rehabilitation options should be thoroughly discussed by patients and therapists prior to treatment.

Imaging Sinonasal disease with MRI: Providing insight over and above CT

This article illustrates and discusses the applications and value of magnetic resonance imaging (MRI) in the evaluation of sinonasal disease. There are several clinical scenarios where MRI can add value over conventional computed tomography (CT) evaluation of the sinonasal spaces. Specifically, MRI can provide insight through better depiction of the anatomy of certain sinonasal sub-sites including the olfactory structures. It can aid in evaluating anosmia, sinusitis (fungal sinusitis and complications), benign and malignant lesions, CSF leaks and pathology extending into sinonasal spaces.