Guest: Dr. Rodney J. Schlosser – ENT
Host: Dr. Linda Austin – Psychiatry
Dr. Linda Austin: I am Dr. Linda Austin and I am interviewing Dr. Rodney J. Schlosser. Today, we are going to be talking about sinus tumors. Dr. Schlosser, there are so many relatively not serious problems of the sinuses, sinusitis, sinus polyps that can be readily removed with surgery, but every once in a while it’s not so simple, I am sure. How does a doctor go about diagnosing a tumor something significant of the sinuses?
Dr. Rodney J. Schlosser: Your suspicion has to be raised for a tumor and by the term tumor, it can be benign or malignant growth. If the symptoms are primarily on one side as opposed to the other or if there are other symptoms such as pain, sometimes facial numbness, or bleeding, those usually can occur with run-of-the-mill sinus condition such as an infection or polyps, but they are much less likely, so if I hear those types of symptoms, my suspicion level is increased significantly.
Dr. Linda Austin: And what do you do then to clarify the diagnosis?
Dr. Rodney J. Schlosser: Really, the first step is to probably get some type of an x-ray and typically a sinus CT or a CAT scan is going be the first step and if you identify a mass there, then that’s when it probably needs to be sent to an ear, nose, and throat specialist for consideration of a biopsy to make the definitive diagnosis.
Dr. Linda Austin: Can you give rough statistics about what fraction of such tumors or masses are benign versus malignant?
Dr. Rodney J. Schlosser: It’s probably about 80% to 90% of tumors in the nose are benign and the most common one is called inverted papilloma. It is similar to papilloma or warty-like growths that occur on your fingers, your toes, or other parts of the body and that’s the most common one.
Dr. Linda Austin: So, relatively rare than they have a malignant tumor?
Dr. Rodney J. Schlosser: Yes.
Dr. Linda Austin: Do you end up operating though either way?
Dr. Rodney J. Schlosser: It depends on the type of tumor, but the majority of sinus tumors are treated surgically. The thing that we are doing here at MUSC, which is really one of the leading institutions in the countries is that most of these tumors now we can take out endoscopically with a small scope that is placed through the nostril without any external incisions in the face. So, it is similar to minimally invasive surgery that is being performed in other parts of the body and we just have a phenomenal team of surgeons that works on these patients that includes neurosurgeons, my head and neck cancer colleagues, and even radiation specialists, who only deal with tumors in this area and are just outstanding, one of the best group of doctors I have ever worked with.
Dr. Linda Austin: It’s interesting to think of what must be anatomically a very small problem yet can cause very big difficulties and takes a whole team of people to sort out.
Dr. Rodney J. Schlosser: Absolutely, because these tumors where the sinuses are located, it’s within just a millimeter to two of critical structure such as the brain, the eye, the optic nerve, the carotid artery, and so these tumors really have to be removed in a very meticulous and precise fashion and so it really is absolutely critical that this be done in a meticulous fashion by someone who is experienced in that.
Dr. Linda Austin: Hopefully, then one would get the tumor, hopefully would be benign. If that were malignant, you would hope to get it all out. I am sure once in while that doesn’t happen. In such a case, if you can’t get it all out, what happens next?
Dr. Rodney J. Schlosser: It depends on the type of tumor, but sometimes postoperative radiation therapy and/or chemotherapy can be used and so it really depends on the tumor type and its individualized treatment at that point.
Dr. Linda Austin: Dr. Rodney J. Schlosser, thank you so much and I congratulate you on the great work you are doing here.
Dr. Rodney J. Schlosser: Thank you.
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