2.1.

Definition

The tumor is a new network (neoplasm) that arise in the body due to the influence
of various factors and cause local tissue at the level of genes and their loss of normal
controls on growth. Maxillary tumor is a growth of new tissue that occurs in the
maxillary sinus tend to invade surrounding tissues and metastasis to distant places.

2.2 Etiology
1. The etiology of sinonasal malignant tumors is not known with certainty, but it is
suspected some industrial chemicals or substances is the cause of, among others, nickel,
wood dust, leather, formaldehyde, chromium, isopropyl oil and others. Workers in this
field got the possibility of a much larger sinonasal malignancies. Alcohol, cigarettes
smoked, salted or smoked foods thought to increase the likelihood of malignancy,
whereas fruits and vegetables reduce the possibility of malignancy.
2. Exposure to radioactive Thorotrast in a long time increases the risk of the maxillary
sinus tumor
3. Chronic sinusitis increases the risk of tumor formation
4. Consumption of tobacco increases the risk of the formation of the maxillary sinus
tumors (squamous cell carcinoma), although the mechanism and the effects of tobacco on
the increased risk is not known for sure

1. Pathophysiology
Tumor spread locally as protrusions wounding and lethal to cells that around.
Growing tumors can kill the cells around by pressing these cells or to destroy the blood
supply and release of chemicals and enzymes that destroy the integrity of the membrane
surrounding the cell, so that the cells undergo lysis and death. Once the dead cells around
the tumor can easily grow to occupy the space vacated.
2.2.Clinical manifestations

Symptoms depend on the origin of the primary tumor as well as the direction and
expansion. Tumors in the maxillary sinus is usually asymptomatic, but usually no secret
blood obtained their nose and nasal obstruction symptoms. Other symptoms may occur
after a large tumor, can induce bone or penetrate walls and extends into the nasal cavity
or mouth, cheek, or the orbit.
Depending on the expansion of the tumor, the symptoms can be categorized as follows:
1. Symptoms of nasal form of unilateral nasal obstruction and rhinorea. Often mixed with
blood or secretions occur epistaxis. Large tumors can urge the nasal bone, causing
deformities of the nose. Typical of his nose smelled malignant tumors because they
contain necrotic tissue.
2. Symptoms of orbital. tumor extension into the orbit causing diplopia, proptosis, or
protrusion of the eyeball, ophthalmoplegia, impaired vision and epistrophe.
3. The oral symptoms. Expansion of tumor kerongga mouth ulcers can cause bulging or
palate or alveolar process. Patients complain of shaky teeth. Often patients come to the
dentist because of dental pain, but did not recover even though the tooth has been
removed.
4. Symptoms facial. Expansion of tumor future will lead to bulging cheeks, accompanied
by pain, anesthesia or paresthesia advance if the trigeminal nerve.
5. Symptoms of Intracranial. Expansion of intracranial tumor to cause severe headache,
ophthalmoplegia and impaired vision. Can be accompanied likuororea, the cerebrospinal
fluid that comes out through the nose. If the extension into the cranial fossa media then
other brain nerve will be exposed. If the tumor extends rearward, there trismus from
involvement disetai pterygoid muscle and paraesthesia local anesthesia in persarafi
maxillaries and mandibular nerve.
6. The spread to the lymphatic system of the submandibular and deep cervical nodes (on
the state of metastatic tumor)
When the patient's own tumor treatment usually in the late phase. It also led to late
diagnosis is due dininya symptoms similar to chronic rhinitis or sinusitis so often
neglected patients and physicians
2.3.Management

1. Surgery
Surgery or more frequently together with other therapeutic modalities such as radiation
and chemotherapy as an adjuvant to this day is still the main treatment for malignancy on
the nose and paranasal sinuses. Surgery is contraindicated in cases of metastatic far, has
been extended to bilateral cavernous sinus or the tumor is on the second orbit. In tumor
extirpation of benign tumors made as clean as possible. If necessary rinotomi lateral
approach or degloving.
For malignant tumors such as maksilektomi radical action is taken, it can be
maksilektomi media, total and radical. Maksilektomi radical usually done for example in
tumors that have been infiltrating into the orbit, consists of removal of the maxilla in
endblok accompanied eksterasi orbit, if the tumor extends into the intracranial cavity
craniofacial resection or craniotomy, the actions carried out in the team together
neurosurgeons (2).
2. Chemotherapy
Helpful chemotherapy in malignant tumors with metastases or recurrent or type that is
very good with chemotherapy, such as lymphoma malignum. The role of chemotherapy
for sinonasal tract tumor treatment is usually palliative, use Cytoreductive effect to
reduce pain and blockage, or to shrink the massive external lesions. The use of high-dose
cisplatin intrarterial can be used concurrently with radiation in patients with carcinoma of
the paranasal sinuses. 5-year survival rate of 53%. Patients who show risk of surgery is
poor and who refused to do surgery be considered for a combination of radiation and
chemotherapy (2,9).
3. Radiation
Radiation is used as the sole method to help surgery or as palliative therapy.
Postoperative radiation can control locally but not cause-specific survival or absolute.
Tumor cells that little can be killed, the edge of the non-radiation tumors can be restricted
throughout the surgery and post operative wound healing are more predictable