Approach to sinonasal masses: A comprehensive review

The complex anatomy and exposure to various potential carcinogens lead to the development of tumors and tumor-like pathologies of the nose and paranasal sinuses. Delays in the diagnosis of sinonasal masses are common, leading to significant morbidity and mortality. Often the radiologist is the first person to recognize a neoplasm in a suspected inflammatory condition. Computed tomography and magnetic resonance imaging play a synergistic role in the assessment of pathologies in the sinonasal region, and their importance has become increasingly prevalent in the current scenario of coronavirus disease 2019 associated mucormycosis. Besides, imaging is essential for mapping the exact extent of the pathology and delineating vascular supply of hypervascular masses, thus facilitating the operating surgeon and interventional radiologist in management. The cases presented in this article have been accrued over the past three decades and analyzed as a retrospective observational study, with clinical, radiological, and pathological data having been extracted from the existing database in the institution. We present the imaging spectrum of sinonasal masses in the pediatric and adult population, highlight the key radiological features of the common pathologies and discuss an imaging template for reporting these masses, with special focus on the surgically relevant points to be included in the report. The educational goal of this review is to explore a meticulous and systematic imaging approach toward soft tissue lesions in the sinonasal region, which would enable the radiologist to reach a diagnosis or point toward the possible etiology and nature of the lesions.