Facial Assymetry, What Is Happened ?

Facial Asymmetry, What Is Happened ?

The nose is the most prominent part of the face, separated by the nasal septum which divides the nasal cavity into right and left. There is hollow bony structures filled with air around the nose, known as the paranasal sinuses. The paranasal sinuses play a role in sound resonance, humidify and warm respiratory air, reduce the weight of the skull and increase resistance to mechanical trauma. The maxillary sinus is the largest of the paranasal sinuses and is the most common site of malignancy in the nose and paranasal sinuses.

Malignancies of the nose and paranasal sinuses, also known as sinonasal carcinomas, rank second in Asia of all malignancies in the head and neck region, after nasopharyngeal carcinoma. Sinonasal carcinoma is a disease associated with the environment. Several studies have stated that exposure to chemicals or industrial materials, such as nickel, wood dust, chromium, furniture, textiles, and other materials is associated with the incidence of malignancy in sinonasal areas. Consumption of alcoholic beverages, salted foods, smoked foods and exposure to cigarette smoke is also thought to increase the risk of sinonasal carcinoma.

Malignant tumors of the nose and paranasal sinuses are rarely found at an early stage. This is because the symptoms are not specific and similar to influenza, such as :  a runny nose, nasal obstruction or headache. However, at advanced stage, this symptoms usually accompanied by a foul-smelling and bloody nasal secretion, persistent nasal obstruction, a lump on the cheek, protruding eyes due to the urge of the tumor, blurred vision, tingling in the face, and severe headache. On nasal endoscopic shows a tumor mass with an irregular surface, necrotic areas and bleeds easily.

Sinonasal cancer is enforced through histopathology examination of tumor tissue. The staging of sinonasal carcinoma is obtained from the expansion of the tumor to the surrounding structures, the presence of lymph nodes tumor and the presence of tumor metastasis. Laboratory test, chest X-ray, head and neck CT scan are performed to determine the stage of the disease.

Surgery is the main treatment in sinonasal carcinoma. Sinonasal area surgery is quite complicated because sinonasal is close to eyes and brain. Several surgical approaches were chosen based on tumor expansion and cosmetic considerations, including: lateral rhinotomy, midfacial degloving and nasoendoscopy. Neck dissection is performed if there is expansion of the tumor to the lymph nodes. Radiation therapy in sinonasal cancer can be done after surgery, while chemotherapy can be given before radiotherapy, concomitant with radiotherapy or as adjuvant therapy. Sinonasal carcinoma has a poor prognosis, so early detection is necessary.