Pattern of Growth and Clinical Evaluation
During the early phase of growth, sinonasal tract malignancies are characterized by the absence of symptoms or by the presence of mild and nonspecific complaints. In a review performed by Tufano et al. (1999), the mean duration of symptoms was 20 months. Consequently, diagnosis is mostly achieved when the disease is locally advanced (Paulino et al. 1998) and the tumor has already involved adjacent structures such as hard palate, nasal fossa, masticatory space, premaxillary soft tissues, skin, orbit, or anterior cranial fossa. At this stage, signs and symptoms become more typical and related to specific pathways of spread.
For these reasons, symptoms of sinonasal tract malignancies will be discussed according to topographic criteria, with the intent to describe the typical pre sentation for each anatomic subsite. Squamous cell carcinoma and adenocarcinoma will be considered as tumors typically affecting the maxillary sinus and the ethmoid, respectively. Peculiar signs and symptoms for specific histotypes will be instead discussed in the dedicated sections.
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