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Sell et al. Mini-invasive Surg 2024;8:3 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2023.105

Review Open Access

Contemporary surveillance of sinonasal malignancy

in adults

2
1
Elizabeth A. Sell , Kush Panara 2 , Alan D. Workman , Nithin D. Adappa 1,2
1
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
2
Division of Rhinology and Skullbase Surgery, Department of Otorhinolaryngology-Head and Neck Surgery, University of
Pennsylvania, Philadelphia, PA 19104, USA.
Correspondence to: Dr. Nithin D. Adappa, Division of Rhinology and Skullbase Surgery, Department of Otorhinolaryngology-
Head and Neck Surgery, University of Pennsylvania, 5th Floor Ravdin Building, 3400 Spruce Street, Philadelphia, PA 19104, USA.
E-mail: Nithin.Adappa@pennmedicine.upenn.edu

How to cite this article: Sell EA, Panara K, Workman AD, Adappa ND. Contemporary surveillance of sinonasal malignancy in
adults. Mini-invasive Surg 2024;8:3. https://dx.doi.org/10.20517/2574-1225.2023.105

Received: 21 Sep 2023 First Decision: 25 Jan 2024 Revised: 30 Jan 2024 Accepted: 6 Feb 2024 Published: 8 Feb 2024
Academic Editors: Giulio Belli, Ehab Y. Hanna Copy Editor: Dong-Li Li Production Editor: Dong-Li Li

Abstract
Sinonasal malignancies are a unique subset of head and neck cancers that necessitate close monitoring due to high
local recurrence rates. Surveillance consists of a combination of endoscopy, imaging, and patient-reported
symptomatology, but no standardized surveillance protocols currently exist. Strategies historically have been based
on guidelines for other head and neck malignancies; however, the unique anatomical and histologic presentation of
sinonasal malignancies presents challenges. This review discusses the literature surrounding the utility of each of
the different surveillance modalities and highlights techniques under investigation to aid clinicians in optimizing the
surveillance of sinonasal malignancies.
Keywords: Sinonasal cancer, sinonasal squamous cell carcinoma, sinonasal adenocarcinoma, sinonasal endocrine
carcinoma, sinonasal malignancy, sinonasal undifferentiated carcinoma, surveillance

INTRODUCTION
Sinonasal malignancies make up less than 5% of all head and neck cancers, but while outcomes of many
other head and neck cancers have increased dramatically over the last ten years, outcome metrics in
sinonasal malignancy have remained relatively stagnant by comparison . Even for resectable lesions with
[1,2]
negative margins, recurrence rates are between 30%-50% for sinonasal malignancies with the vast majority

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