Diagnostic errors in cancers of the nasal cavity and paranasal sinuses. The essential role of surgery.

Two hundred eighty-two cases of 624 cases of carcinoma of the nasal cavity and paranasal sinuses were studied. All had a clinical evaluation of the extent of carcinoma, followed by surgical procedures. By a process of defining 13 possible compartments or extensions and enumerating them before and after surgery, it was possible to show that approximately one third of the cases had errors in preoperative assessment. Underestimates preponderated. It is suggested that diagnosis is one important role of surgery, in addition to the directly therapeutic effect of excision. Surgery is also essential as a guide to further excision and to the accurate application of radiotherapy treatment fields.