Invasive surgery for paranasal sinus cancer: is there still any indication for lateral rhinotomy and non endoscopic approaches?

A combined intracranial and transfacial approach for often very malignant lesions of the sino-nasal complex yields the best chance of curation. The operative risk diminishes in a centre with a large turnover after an initial learning curve and it is the only possibility to try to cure the patient from his or her disease. The removal of a rather small malignant lesion in the anterior part of the middle meatus can be safely done through the nostril with correct oncologic margins. In case of inoperability because of local destructions or because of the histological type (malignant melanoma e.g.) freeing up the nasal airway endoscopically can help patients symptomatically and repeatedly.