Introduction
This note covers the inflammatory diseases and tumours of the nose and paranasal sinuses, and the tumours of the larynx, with the gross and microscopic features of laryngeal carcinoma in detail.
Inflammatory diseases of the nose and paranasal sinuses
- Acute rhinitis (common cold): usually viral; the mucosa is hyperaemic and oedematous with a watery, later mucopurulent, exudate. Bacterial superinfection may follow.
- Allergic rhinitis: an IgE-mediated type I hypersensitivity reaction; the mucosa is pale and swollen with many eosinophils in the infiltrate.
- Nasal polyps: oedematous, inflammatory masses covered by respiratory epithelium, with stroma rich in eosinophils and mucous glands; they follow repeated allergic or chronic inflammation.
- Sinusitis: acute or chronic inflammation of the paranasal sinuses, usually after rhinitis, as the sinus drainage is obstructed. Complications are spread to the orbit, bone (osteomyelitis) and brain (meningitis, abscess).
- Granulomatous diseases: granulomatosis with polyangiitis (Wegener) can involve the nose and sinuses with necrotising vasculitis and granulomas.
Tumours of the nose and paranasal sinuses
- Inverted (Schneiderian) papilloma: a benign epithelial tumour of the lateral nasal wall and sinuses; it recurs, and can occasionally contain or progress to squamous carcinoma.
- Squamous cell carcinoma: the most common malignant tumour of the sinuses, especially the maxillary sinus.
- Olfactory neuroblastoma and nasopharyngeal carcinoma (linked to EBV) are other important malignant tumours of this region.