• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.3
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• pp.271-275
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• 2001

Nine cases of maxillary sinus aspergillosis during a period from February of 1992 to June of 2000 were investigated to analyze the clinical, radiologic and pathologic features. Maxillary sinus aspergillosis is rare disease, but it was increasing tendency with overuse antibiotics, steroid hormones, and anticancer agents. Aspergillosis of the maxillary sinus may occur as a chronic disease in an otherwise healthy person. The clinical features of maxillary sinus aspergillosis were similar to the non-fungal, chronic sinusitis. Intrasinus calcification is known to be a characteristic feature of maxillary sinus aspergillosis. It is suggested that excess root filling materials containing zinc oxide in the maxillary sinus could favour the formation of a local, non-invasive maxillary sinus aspergillosis. And this "dental" model of pathogenensis of maxillary sinus aspergillosis is an alternative to the widely accepted concept of spore inhalation and "aero-genic" pathogenensis of maxillary sinus aspergillosis. The radical surgery such as Caldwell-Luc operation was one of the most effective treatment modalities. Our results of this study indicate that maxillary sinus aspergillosis might occur mainly in healthy individuals rather than debilitating patients. It could efficiently treated with radical surgery alone without the antifungal agents. 4 cases were suspected to be related with teeth extraction and endodontic treatment. There were no recurrence in all cases.

• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.145-152
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• 1995

A retrospective analysis was performed to ascertain the relationship between the treatment modalities and their treatment results. From July 1980 to June 1993, 115 patients with squamous cell carcinoma of the maxillary sinus were: treated at the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University. There were 88 men and 27 women with median age of 57 years. According to AJCC TNM system of 1992. eight patients of T2, 54 patients of T3 and 53 patients of T4 were available, respectively. Cervical lymph node metastases at diagnosis was observed in 11 patients. 87 patients were treated with radiotherapy and 28 patients were treated with combination of surgery and radiotherapy. The overall 5 year survival rate was 32 %, patients that were treated with radiotherapy alone had a 5 year survival rate 24.3 % and patients who were treated with combination of surgery and radiation therapy had a 5 year survival rate of 52.8 % (p<0.05). Combination of surgery and radiotherapy resulted in a better treatment modality for squamous cell carcinoma of the maxillary sinus. Improved radiotherapy technique and development of multimodality treatment are needed to improve the local control and the survival rate in patients with advanced maxillary sinus carcinoma.

• The Korean Journal of Pain
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• v.6 no.1
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• pp.100-104
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• 1993

Malignant tumors of the paranasal sinuses are quite rare entity, with maxillary neoplasms accounting for less than 1 percent of all head and neck malignancies. When considering the paranasal sinuses alone, 77 percent of cancers arise in the maxillary sinuses. There is no situation more frustrating than the management of the patients with chronic facial pain due to cancer. The initial step in managing patients with cancer pain is the use of oncologic therapy in the form of radiotherapy, surgery, chemotherapy, alone or combined, either to effect a cure or decrease the size of the tumor and thus decrease or eliminate the pain. When oncologic therapy is ineffective in providing relief, the pain must be treated by one or more of the followings: Systemic analgesics and adjuvant drugs, psychologic techniques of analgesia, neurostimulating techniques, neuroablative surgical procedures, regional analgesia with local anesthetics or neurolytic blocks. An 82-year old patient had severe pain of the orbital and infraorbital region due to squamous cell carcinoma of the maxillary sinus. We successfully treated this patient with the percutaneous retrogasserian ethanol gangliolysis by a H$\ddot{a}$rtel approach, and the analgesia lasts until the death of the patient.

• The Journal of the Korean dental association
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• v.10 no.2
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• pp.87-90
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• 1972

The carcinoma of the maxillary sinus occupies about 0.25% of all human cancers. The radiations therapy for maxillary sinus hs not been practiced widely in this country. The authors treated a case of relatively advanced maxillary sinus cancer with combined radium and external irradiation with a succesful result. The clinical course and treatment are introduced and evaluated in detail. The authors believe that the carcinoma of the maxillary sinus is a curable disease even though it is relatively advanced one.

• Korean Journal of Head & Neck Oncology
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• v.12 no.2
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• pp.217-223
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• 1996

A retrospective analysis was performed to assess the relationship between the treatment modalities and treatment results in patients with adenoid cystic carcinoma of the maxillary sinus. From Feb. 1977 to March 1994, 10 patients with the disease were treated at the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine. Six men and 4 women were presented with median age of 57 years. According to AJCC TNM system, all patients except one had advanced T3 and T4 disease. Only one patient had the regional metastasis to lymph node but none of them had hematogenous metastasis on initial admission. One patient(Group 1) was treated with surgery alone, 3 patients(Group 2) were treated with definitive radiotherapy and 6 patients(Group 3) were treated with combination of surgery and radiotherapy. One patient who was treated with surgery alone had experienced a locoregional recurrence 9 months later and 3 patients who were treated with radiation therapy alone had PRs(partial response) followed by the subsequent progression of the local disease. Whereas all patients who were treated with combination of surgery and radiation therapy had CRs(complete response). Among them, only one patient was recurred in the primary site, who was salvaged by reoperation and reirradiation therapy. In conclusion, combination of surgery and radiotherapy resulted in the best treatment modality for adenoid cystic carcinoma of the maxillary sinus. Improved radiotherapy technique and development of multimodality treatment are needed to improve the local control and the survival rate in patients with advanced adenoid cystic carcinoma of the maxillary sinus.

• Radiation Oncology Journal
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• v.12 no.3
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• pp.307-313
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• 1994

Purpose : Maxillary sinus cancers usually are locally advanced and involve the structures around sinus. It is uncommon for this cancer to spread to the regional lymph-nodes. For this reason, local control is of paramount important for cure. A policy of combined treatment is generally accepted as the most effective means of enhancing cure rartes. This paper reports our experience of a retrospective study of 31 Patients treated with radiation therapy alone and combination therapy of surgery and radiation. Materials and Methods: Between July 1974 and January 1992, 47 Patients with maxillary sinus cancers underwent either radiation therpay alone or combination therapy of surgery and radiation. Of these, only 31 patients were eligible for analysis. The distribution of clinical stage by the AJCC system was $26\%$(8/31) for T2 and $74\%$(23/31) for T3 and T4. Eight patients had palpable lymphadenopathy at diagnosis. Primary site was treated by Cobalt-60 radiation therapy using through a $45^{\circ}$ wedge-pair technique. Elective neck irradiation was not routinely given. Of these 8 patients, the six who had clinically involved nodes were treated with definite radiation therapy. The other two patients had received radical neck dissection. The twenty-two patients were treated with radiation alone and 9 patients were treated with combination radiation therapy, The RT alone patients with RT dose less than 60 Gy were 9 and those above 60 Gy were 13. Results : The overall 5 year survival rate was $23.8\%$. The 5 year survival rate by T-stage was $60.5\%$ and $7.9\%$ for T2 and T3,4, respectively. Statistical significance was found by T-stage(p<0.005). The 5 year survival rate by N-stage was $30\%$ for N (-) and $8.3\%$ for N(+), but statistically no significant difference was seen(p${\geq}$0.1). The 5 year survival rate for RT alone and combination RT was $22.5\%$ and $27.4\%$, respectively. The primary local control rate was $65\%$ (20/31). Conclusion : This study did not show significant difference in survival between RT alone and combination RT. There is still much controversy with regard to which treatment is optimum. Improved RT technique and development of multimodality treatment are essential to improve the local control and the survival rate in patients with advanced maxillary sinus cancer.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.2
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• pp.125-127
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• 2010

The coexistence of aspergillosis and squamous cell carcinoma (SCC) in the maxillary sinus was very rare. To our knowledge, this is the second report of coexistent SCC and aspergillosis in the maxillary sinus. A 58-year-old man underwent surgery for unilateral maxillary sinus infection with oroantral fistula. In the surgical specimen, SCC and aspergillosis were co-detected with routine and immunohistochemical stainings. Moreover, human papillomavirus 18 (HPV-18) was detected by polymerase chain reaction in the sinus specimen. The patient was re-operated with subtotal maxillectomy and has been followed up for two years without any evidence of recurrence or metastasis. Although it is not understood how aspergillosis could induce carcinoma formation, the chronic inflammation caused by prolonged fungal infection might be carcinogenic. Moreover, HPV-16 and -18 were another causative pathogens of SCC in the head and neck region. We recommend careful examination, including preoperative cytology, in patients with maxillary sinus fungal infections because of the potential for cancer development.

• Korean Journal of Head & Neck Oncology
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• v.20 no.1
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• pp.41-43
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• 2004

An advanced maxillary sinus cancer requires an extensive ablation that results an extensive facial deformity, including a skin defect. Reconstruction has to be considered in a radical maxillectomy, especially with skin defect may be accomplished in one stage with a microsurgical free transfer of a latissimus dorsi flap. A man of right maxillary sinus cancer, squamous cell carcinoma, 47 years old of age, had soft tissue invasion of the cheek region. He underwent a radical maxillectomy with extensive skin excision. The maxillectomy and skin defects were reconstructed with the double skin island latissimus dorsi myocutaneous free flap. The cosmetic result and the functional outcome of the nose were thought to be considerably satisfied.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.1
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• pp.86-90
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• 2002

Sinus lifting was introduced for prosthetic reconstruction in 1960 decades by Boyne and is specifically used for implant surgery in maxillary posterior region with insufficient bony height and has been indicated for reconstruction of oro- antral and palato-alveolar cleft. We report that subtotal maxillectomy using sinus lifting and skin graft in mild maxillary cancer cases results in good prevention of oro-antral and oro-nasal fistula by preserving intact maxillary sinus mucosa and improves better functional outcome after maxillectomy.

• Radiation Oncology Journal
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• v.31 no.3
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• pp.118-124
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• 2013

Purpose: The optimal treatment of advanced maxillary sinus cancer has been challenging for several decades. Intra-arterial chemotherapy (IAC) for head and neck cancer has been controversial. We have analyzed the long-term outcome of neoadjuvant IAC followed by radiation therapy (RT) and surgery. Materials and Methods: Twenty-seven patients with advanced maxillary sinus cancer were treated between 1989 and 2002. Five-fluorouracil (5-FU, $500mg/m^2$) was infused intra-arterially, and followed by RT (total 50.4 Gy/28 fractions). A planned surgery was performed 3 to 4 weeks after completion of IAC and RT. Results: At a median follow-up of 77 months (range, 12 to 169 months), the 5-year rates of overall survival in all patients were 63%. The 5-year rates of overall survival of stage T3/T4 patients were 70.0% and 58.8%, respectively. Seven of fourteen patients with disease recurrence had a local recurrence alone. The 5-year actuarial local control rates in patients with stage T3/T4, and in all patients were 20.0%, 32.3%, and 27.4%, respectively. Overall response rate after the completion of IAC and RT was 70.3%. During the follow-up, seven patients (25.9%) showed mild to moderate late complications. The tumor extent (i.e., the involvement of either orbit and/or base of skull) appeared to be related with local recurrence. Conclusion: Neoadjuvant IAC with 5-FU followed by RT and surgery may be effective to improve local tumor control in the patients with advanced maxillary sinus cancer. However, local failure was still the major cause of death. Further investigations are required to determine the optimal treatment schedule, radiotherapy techniques and chemotherapy regimens.