Imaging and biopsy strategies for sinonasal tumours

Cross-sectional imaging alongside endoscopy is central to the multidisciplinary evaluation of sinonasal pathologies and is often fundamental in differentiating both benign and malignant tumours from the more common inflammatory or infective entities such as primary chronic rhinosinusitis (CRS). In addition to determining disease extent in relation to neighbouring vital craniofacial structures, imaging is key in biopsy and treatment planning as well as post-treatment follow-up.

While CRS is common (affecting 5-12% of adults), sinonasal tumours are rare, with malignancies comprising just 3% of all head and neck cancers. Prognosis is, however, often poor, with advanced disease at presentation. Tumours enlarge within the sinuses asymptomatically and when symptoms do manifest, they frequently overlap with inflammatory disease.

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