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Explore this issue:October 2018
Sinonasal malignancies are rare, representing only 3% of all head and neck neoplasms and approximately 1% of all malignancies. Given this low incidence and the diversity of pathologies, standardized protocols for post-treatment surveillance are lacking. Due to their advanced stage at presentation, sinonasal malignancies often have a poor prognosis, with recurrence rates ranging from 27% to 56%. Whereas the majority of recurrences occur within two to three years post-treatment, certain malignancies, such adenoid cystic carcinoma, olfactory neuroblastoma, and melanoma, have a propensity to recur much later. The majority of recurrences occur locally and represent the leading cause of disease-specific mortality. Several factors, including complex anatomy, treatment-related changes, distortion due to resection and reconstruction, and sinonasal inflammation, complicate surveillance for recurrence. Due to these unique aspects, accepted surveillance guidelines for head and neck malignancies may not be directly applicable for sinonasal malignancies. Accordingly, distinct guidelines for post-treatment endoscopic and radiographic surveillance are needed.
Given the high recurrence rates in sinonasal malignancies, close, routine endoscopic and imaging surveillance is needed in the post-treatment setting. Endoscopy and imaging serve to complement each other.