Management of Nose and Paranasal Sinus Malignancy
Mohit Achanta, ST3 Otolaryngology, Castle Hill Hospital, Hull, UK
The ENT UK Head and Neck Evidence-Based Management Meeting focusing on malignancy of the nose and paranasal sinuses was held in the historic market town of York. The multidisciplinary approach required to manage this complex disease was reflected in the speaker lineup, with national representation from ENT, maxillofacial and plastic surgery, oncology, palliative medicine, histopathology and radiology. The day was punctuated by breaks where attendees ranging from trainees at the start of their training to senior consultants were able to caffeinate and catch up.
The day opened with Louise Melia covering the evidence comparing endoscopic and open approaches in addressing sinonasal malignancy. This was followed by a presentation by James Moor and Robin Prestwich, which looked at whether initial management with surgery or medical oncology offered greater benefit. Professor Ali Khurram was unable to attend the meeting in person, but attendees were grateful that he was able to send in a recorded presentation covering the histopathology and biomarkers of nasal cancer.
Clare Schilling highlighted the importance of craniofacial reconstruction and strategies to address the orbit. Somiah Siddiq and Helen Clarke then updated us on surgical and medical treatment of the neck.
Following the lunch break, James Price presented the evidence behind proton-beam therapy and discussed the recently commenced PROTIS trial, which compares proton-beam to conventional intensity modulated radiation therapy. Shafiq Rahman and Syed Raza followed up with a presentation on the management of mucosal melanoma.
These talks were rounded out by Laura Warner, Shahid Iqbal and Maria McKenna, who underscored the importance of palliative care in patients with paranasal sinus malignancy – where presentation with advanced disease was commonplace and up to 22% of patients had incurable cancer.
The day concluded with an interactive multidisciplinary panel discussion chaired by Navin Mani. Real-world cases were discussed with expert medical, surgical and radiologic input from a panel comprised of James Price, Sharan Jayaram, Clare Schilling, Louise Melia and Alina Dragan.
Themes to take away from this engaging day were that cancers of the nose and paranasal sinuses represented a heterogenous group of rare diseases with significant implications to patients’ mortality and quality of life. Prompt recognition and management with a multi-disciplinary approach is key. Given the continual emergence of evidence in the field,clinicians must stay up to date and engage with multi-centre research opportunities to ensure we provide the best possible standard of care to our patients.
This event was made possible thanks to the time and efforts of Jemy Jose, the Head and Neck Council, ENT UK, and of course the exceptional speakers. The meeting was remarkably well-attended following a post-pandemic hiatus, and plans were made to continue annual Head and Neck Society meetings in the latter half of the year.
Future meeting details: November 21st 2025; Hypopharyngeal Cancer
