The patient's primary care doctor or dentist usually examines the patient first.
The clinical examinations should include:
- thorough inspection of mucosa in the nasal cavity (anterior rhinoscopy)
- thorough palpation of the neck for enlarged lymph nodes
- biopsy of suspect mucosal lesions
For suspected malignancy, the patient should be immediately referred to an ENT specialist/clinic.
At Oslo University Hospital, the following examinations are performed according to the UICC certainty level C2 (4).
- Clinical examination
- Chest CT
- CT/MRI of primary tumor area and neck. The examinations must exclude sinusitis. In addition to objective measurements for primary tumor and metastases, the examination is necessary to determine the extent of surgery and modeling of the radiation field.
- Endoscopic examination
- Sinus-scopy with biopsy as needed. Visualization is improved by topical anesthesia and decongestion of the nasal mucosa.
- Fine needle cytology of:
- regional lymph nodes, possibly guided by ultrasound
- tumor covered by mucosa
Possible additional examinations:
- Regular blood tests to evaluate liver and kidney function, T4 and TSH
- Chest CT in patients with suspected lung metastases/lung tumor
- PET to assess the extent of metastases, and possibly to judge the extent of the tumor for operability.
- If needed, the patient is evaluated by a lung specialist, cardiologist or other specialists for operability.
- Examination by an oral surgeon/maxillofacial surgeon
The staging form is completed and the patient is evaluated by an interdisciplinary team including a head/neck surgeon, medical and radiation oncologists, pathologist, radiologist, and cancer nurse.
Evaluation for recurrence is the same as for a primary tumor.