Factors in the Pathogenesis of Tumors of the Sphenoid and Maxillary Sinuses: A Comparative Study

Abstract

Objectives/Hypothesis To explain the processes that lead to the development of tumors in the maxillary and sphenoid sinuses. Study Design A 32‐year review of the world's literature on neoplasms of these two sinuses and a randomized case‐controlled study comparing the normal mucosal architecture of the maxillary to the sphenoid sinus. Methods Analysis of a 32‐year world literature review reporting series of cases of maxillary and sphenoid sinus tumors. Tumors were classified by histological type and separated into subgroups if an individual incidence rate was reported. Histomorphometry of normal maxillary and sphenoid sinus mucosa was performed in 14 randomly selected patients (10 sphenoid and 4 maxillary specimens). Specimens were fixed in 10% formalin, embedded in paraffin, and stained with periodic acid–Schiff (PAS) and hematoxylin. Histomorphometric analysis was performed with a Zeiss Axioscope light microscope (Carl Zeiss Inc., Thornwood, NY) mounted with a Hamamatsu (Hamamatsu Photonics, Tokyo, Japan) color‐chilled 3 charge coupled device digital camera. The images were captured on a 17‐inch Sony (Sony Corp., Tokyo, Japan) multiscan monitor and analyzed with a Samba 4000 Image Analysis Program (Samba Corp., Los Angeles, CA). Five random areas were selected from strips of epithelium removed from each sinus, and goblet and basal cell measurements were made at magnifications ×100 and ×400. Results The literature review revealed that the number and variety of tumors in the maxillary sinus are much greater than those in the sphenoid. The incidence of metastatic lesions to each sinus is approximately equal. No recognized pattern of spread from any particular organ system could be determined. On histomorphometric study there were no statistically significant differences between the sinuses in the concentration of goblet cells, basal cells, or seromucinous glands. Conclusions Factors involved in the pathogenesis of tumors of the maxillary and sphenoid sinuses include differences in nasal physiology, embryology, morphology, and topography. There are no significant histological differences in the epithelium and submucous glands between the two sinuses to explain the dissimilar formation of neoplasms.

Microscopic study of certain age‐related structural changes of maxillary sinus lining epithelium in albino rats

“…Historically, development of human maxillary sinus supposed to grow as mucosal recesses from the nasal mucous membrane in the third or fourth fetal months, a process known as primary pneumatization (Weiglein,1999). Secondary pneumatization leads to further growth of the maxillary sinus by osteoclastic activity of the surrounding bone; most of the secondary pneumatization occurs postnatally (Reino,2000). Wake et al (1994) found that initially the human fetal nasal cavity is lined by a single layer of flattened cells then stratified epithelium appears at 9 weeks of gestation in the nasal cavity and between 14 and 16 weeks of gestation in the primitive ethmoid and maxillary sinuses.…”

“…Development of the human maxillary sinus occurs prenatal as an invagination into the nasal capsule; a process termed primary pneumatization (Weiglein,1999). Then the sinus slowly develops until its growth is completed in the second decade of life (Reino,2000). Recently, the primary physiological importance of paranasal sinuses is to constitute an important barrier for protection and defense of the sinonasal cavity (Boyce and Eccles,2006; Özdemir et al,2010).…”

Septum submucosal glands exhibit aberrant morphology and reduced mucin production in chronic rhinosinusitis

“…Previous studies have described SMG density in the sinuses and turbinates to be impacted by inflammatory conditions. [8][9][10]17 Considering this, we wanted to determine the effect of CRS on the density and morphology of the SMGs of the posterior septum. To do so, we analyzed nasal biopsies collected from the posterior septum (Figure 1A) from healthy control individuals (n = 14), and participants with CRSsNP (n = 4) and CRSwNP (n = 8, Table 1) using hematoxylin and eosin (H&E) staining in combination with AB to detect mucins.…”

A Rare Case of Metastases to Paranasal Sinus From Colonic Adenocarcinoma

“…Incidences of these metastases are common in the 50 and 60 years age group of men and 60 and 70 years age group of women [2]. A review of literature on tumors of paranasal sinuses reports very few cases of sinonasal metastases from colorectal carcinoma [3][4][5][6][7][8].…”