TY - JOUR T1 - Nose and sinus tumours: red flags and referral JF - British Journal of General Practice JO - Br J Gen Pract SP - 247 LP - 248 DO - 10.3399/bjgp18X696137 VL - 68 IS - 670 AU - Christopher A Slinger AU - Gerald W McGarry Y1 - 2018/05/01 UR - http://bjgp.org/content/68/670/247.abstract N2 - Sinonasal tumours are rare, accounting for 3% of all head and neck malignancies and <1% of all malignancies.1–4 In addition to rarity, they present with nonspecific and often seemingly benign symptoms, which makes them difficult to diagnose early. Awareness of sinonasal tumours as an entity and familiarity with the key and often misinterpreted symptoms is essential for early diagnosis. This article examines the symptoms, signs, presentation, investigation, and management of nasal and sinus neoplasia, and details the ‘red flags’ that should trigger specialist referral.The sinuses are four pairs of air-filled bony chambers within the facial skeleton and anterior skull base region. The four pairs are the frontal, ethmoid, maxillary, and sphenoid.Their location in the skull dictates that they are surrounded by complex anatomy. Therefore, malignancy can present in many ways and can affect many structures (Box 1).Box 1. Anatomical spread and relevant symptomsTumour spreadSpread/structureSymptomFrontal Inferior: orbit and contentsAnterior: skinPosterior: brain ProptosisVisible extrusionNeurological sequelaeEthmoid Superior: anterior cranial fossaAnterior: lacrimal regionMedial: nasal cavityPosterior: optic nerveLateral: orbit (lamina papyracea) Neurological sequelaeLacrimal swellingNasal obstruction, epistaxis, nasal dischargeVisual disturbanceProptosisMaxillary Superior: orbitInferior: alveolusAnterior: skinPosterior: pterygopalatine fossa (maxillary … ER -