Expert Care for Tumors of the Nasal Cavity, Sinuses and Anterior (floor of the brain) Skull Base
There are a multitude of disease processes that can occur in the nose, sinuses, and along the bony surface between the brain and the sinuses. Nasal/sinus tumors are abnormal growths that occur in the nasal cavities (the passages that you breathe through) or the sinuses (air-filled spaces above, between, and below your eyes). Tumors in these regions can be benign or malignant. Once discovered, work-up would include nasal endoscopy (looking in the nose with a scope), imaging to get a complete picture of the lesion of concern, and ultimately biopsy to confirm or rule out cancer. Once all information has been gathered, our multidisciplinary team meets at our tumor board - a gathering of providers from neurosurgery, ENT, and radiation oncology - to discuss patients in a group setting. This allows multiple providers to share their expertise and determine the best approach and individualize patient care. Once recommendations are made, these are reviewed with the patient and all questions answered.
Your health is important. Don’t delay your care.If you have been diagnosed with a nasal, sinus or anterior skull base tumor, it is important to consult with a UH ENT expert for an accurate diagnosis and an effective treatment plan. Call 440-732-3821 today to schedule an in-person or virtual appointment.
Types of Sinus, Nasal Cavity and Anterior (floor of brain) Skull Base Tumors
Tumors in the nose, sinuses and base of brain can be either benign (noncancerous) or malignant (cancerous). These tumors can be accessed through the nose and procedures are performed in conjunction with neurological surgery if they are close to or involve the brain.
The most common types of benign tumors include:
- Schneiderian papilloma. A tumor that arises from the lining of the nose and sinuses. There are three major types of Schneiderian papilloma - fungiform, inverted, and oncocytic. Although typically benign, up to 10 percent of individuals with inverted or oncocytic tumors can have concurrent cancer, therefore, wide surgical excision and long-term follow-up are recommended.
- Pituitary adenoma. A benign tumor that arises from the pituitary gland, a gland at the base of the brain that controls and coordinates the release of hormones responsible for many of the body’s functions. Tumors in this region are classified by their size and the cells from which they originate.
Less common types of benign tumors that can arise in the sinus, nasal cavity or anterior skull base include:
- Juvenile nasopharyngeal angiofibroma (JNA) - A vascular tumor that forms in the nasal cavity. Although it is noncancerous, it can grow large and cause symptoms most notably one sided nasal breathing problems and bleeding.
- Hemangioma. A benign tumor made up of an abnormal cluster of blood vessels.
- Fibrous dysplasia. A condition in which fibrous, scar-like tissue develops in place of normal bone. Although noncancerous, the area of fibrous tissue can grow over time, weakening the bone and making it more prone to injury, fracture or deformity.
- Osteoma. Slow-growing, bony outgrowths that form on the bones of the skull. They are benign and usually do not cause any symptoms and are often discovered on imaging studies.
- Meningioma. A rare tumor that forms on the membranes surrounding the brain and spinal cord. Although noncancerous, some may cause symptoms such as vision changes, headaches and hearing loss and require treatment.
- Craniopharyngioma. A rare type of benign brain tumor that arises from the pituitary gland, a pea-sized structure at the base of the brain that coordinates the release of hormones responsible for many of the body’s functions. As it grows, it can affect the function of the pituitary gland and other nearby structures.
- Rathke’s cleft cyst. A relatively rare, non-cancerous, fluid-filled growth that develops between the parts of the pituitary gland at the base of the brain.
There are also many types of malignant (cancerous) tumors that can arise from the sinus, nasal cavity or anterior skull base. If it is determined that a tumor is cancerous, our team will collaborate with experts from UH Seidman Cancer Center to develop the most appropriate and effective treatment plan whether it be surgical or non-surgical treatment.
Expertise to Diagnose Sinus, Nasal Cavity and Anterior (floor of brain) Skull Base Tumors
Tumors of the nose, sinuses, and skull base are often discovered based on the symptoms the patient is experiencing. With tumors of the nose and sinuses, individuals can present with nasal breathing problems, progressive loss of smell, nosebleeds, facial swelling, nasal drainage or facial pressure. Tumors of the skull base can cause double vision or vision changes, facial numbness, headaches, double vision, or hormonal issues related to pituitary dysfunction. Tumors at the junction of the ear and brain can cause progressive hearing loss, ear ringing, unsteadiness, facial numbness, or problems moving one side of your face.
These types of tumors can also be discovered during imaging for other issues such as headaches, facial trauma, or issues related to the cervical spine or neck.
If you are experiencing any of the symptoms listed above, it is important to be evaluated by a specially trained ear, nose and throat specialist.
Personalized Treatment Plans for Patients with Skull Base Tumors
The treatment goal for patients with tumors of the nasal cavity, sinuses and anterior skull base is to resolve symptoms and minimize any long-term side effects that may be experienced from any proposed medical treatment or surgical procedure. For malignant tumors, the goal is long-term survival with the highest quality of life attainable.
Based on the information about your tumor obtained during the physical examination and diagnostic tests, a comprehensive treatment plan will be developed, which may include one or more of the following:
- Watchful Waiting
Also called active surveillance, watchful waiting may be the initial treatment approach for some patients, depending on the size and location of the tumor and the degree to which the symptoms are affecting their quality of life. If their symptoms are manageable, a watchful waiting approach is more likely with elderly patients for whom surgery might pose a higher risk.
- Skull Base Surgery
When surgery is determined to be necessary, our surgeons are specifically trained and highly experienced in the surgical removal of tumors of the skull base. The goals of the surgery are variable based on type of tumor, location and each patient’s needs and expectations. Essentially, total removal of the lesion of concern is our expectation but the location of the tumor, potential complications and expected prognosis may alter the surgical plan. Our goal is always to keep our patients as informed as possible throughout the treatment process.
- Radiation Therapy
Radiation therapy is another option for treatment of tumors of the nose, sinuses and anterior skull base. Considerations for its use include type of tumor, location and size of the tumor, and the general health of the patient. Experts at University Hospitals use the most advanced image-guided radiation therapies to target the tumor including Gamma Knife and proton therapy which delivers extremely precise radiation dosing with limited exposure to surrounding healthy tissues.