The position of your cancer and the type of operation you have may affect you in one or more ways.
How you might be affected
Surgery for nasal and paranasal sinus cancer may affect you in one or more of the following ways:
- how you breathe
- how you chew and swallow
- your sense of smell
- how you see
- how you hear
- how you speak
How you might be affected will depend on the position of your cancer and the type of operation you have.
These changes may happen because your face and neck are swollen and sore after surgery. They will usually reduce or disappear once you start to heal. Swelling might also change how you look, but this will usually get better too.
You might have some permanent changes in what you can do and the way you look.
Before you have the surgery, your doctor will discuss the side effects with you.
Changes to your appearance
Surgery for nasal cavity or paranasal sinus cancer can change the way you look. How you look is an important part of your self esteem. It can be very hard to accept sudden changes in your looks that you are not happy with.
If you have had facial surgery, it might be hard to look at yourself in the mirror at first. You might feel very angry, confused and upset for some time afterwards. Before your operation you will see your specialist head and neck nurse. They will discuss all the possible changes to your appearance and how these might make you feel.
It can be very upsetting to go through a cancer diagnosis and then a big operation that changes how you look. You are likely to have times when you feel very down. Try to take time to recover fully from the operation. You’ll need a lot of support from your doctors and nurses, and your family and friends. So lean on them for help as often as you need to.
Temporary changes in how you breathe
Some surgery can temporarily affect how you breathe. The airflow through the nose can change after removal of the tumour. This can lead to build up of mucus or crust in the cavity. Daily washing of the nose with salt water can help to reduce this but sometimes the crust may need to be removed by your doctor in the clinic. Usually, the crusting gets better with time.
You might have a reconstruction of part of your face with a tissue flap. This means that you might need to breathe through a tube in a hole in your neck. You do this until the wound has healed. The hole in your neck is called a temporary breathing stoma or tracheostomy.
Changes to speech, chewing and swallowing
Your surgeon will always try to avoid changes to your speech, chewing or swallowing as much as they can. Sometimes this isn't possible, and you will need to deal with changes after the surgery. This can be very hard to deal with, but there are things that can help.
Loss of sense of smell and taste
Your sense of smell will decrease after some types of surgery. This is especially noticeable if your nose is packed after the surgery. Once the pack comes out, it might improve. But it can take up to 3 months for your sense of smell to come back.
Sometimes the lining at the top of the nose which contains the smell receptors is involved in the cancer and/or has to be removed which will lead to permanent loss of smell. Loss of smell will also affect your ability to appreciate the flavour of food and drink but basic tastes such as salty, sour, bitter and sweet will not be affected.
It can be difficult to cope with not being able to smell.
Parts of your face might be numb after surgery. The numb areas might include the tip and side of your nose, cheek, upper lip or gums. The sensation usually comes back after a few weeks. But sometimes it can take several months or might be permanent. Not being able to feel parts of your nose, cheek or mouth can be difficult to cope with.
Changes to your eyesight
If your surgery affects the eye socket, you might have swelling and bruising around the eye. This is usually only a temporary problem.
Sometimes you may have double vision after surgery if it is done close to the eye. This is often temporary but if it persists, you may need treatment.
You may also get watering of the eye after sinus surgery as the tear duct runs close to the nose and sinuses. Again this is often temporary but if it persists, it can be treated.
Rarely, the surgeon needs to remove the eyeball if it is affected by the cancer. This will cause changes in your eyesight which can be hard to cope with.
Changes to your hearing
Sometimes the swelling at the back of the nose caused by surgery can reduce your hearing, due to fluid collecting in the middle ear space. This is usually only a temporary problem while you recover. Your hearing should get back to normal when the swelling goes down but can be treated if it persists.
After surgery to remove lymph nodes from your neck, you are at risk of getting lymphoedema in your neck or face.
Lymphoedema in the head or neck can also cause symptoms inside your mouth and throat. This may include swelling of your tongue and other parts of your mouth.
Tell your doctor if you have:
- any swelling or a feeling of fullness or pressure
- find it difficult to swallow
- have changes in your voice
Using your head, neck and shoulder muscles may help to reduce swelling. Your physiotherapist or specialist nurse will usually go through these exercises with you.
These exercises shouldn't be painful. You might have a feeling of stretching as you do them, this is normal. Stop doing the exercises if you have any pain and, if doesn't get better contact your doctor.
Do the exercises slowly and gently, don't rush them. You can rest between exercises. It might help to do them in front of the mirror so you can check that your shoulders are back and relaxed.
Exercises for head and neck lymphoedema
Hi, I’m Carla. I’m going to show you how to do head and neck exercises. Remember to do your deep abdominal breathing exercises before and after. Each exercise you will do 5 to 10 times and very important , pain free.
We’ll start with the head and neck. We’ll do looking to the side, back to the middle and to the other side. It’s normal to feel a bit of stretch sensation.
Next one will be ear to the shoulder, not shoulder to the ear. Go back to the middle and to the other side. If you’re not sure you’re doing it right, sometimes it’s helpful to do it in front of a mirror.
Next one will be chin to the chest and back to start position.
Next one will be shoulders. We’ll go up, relax and down and relax.
Next one will be circles. And we go backwards and then forward.
We’ll do as well mouth exercises. We’ll start with open and close. Blowing kisses, blowing candles, exaggerated smile. And then you say the vowels in an exaggerate way
And we’ll do as well the jaw exercises. We’ll do side to side first.
And then moving the jaw forward and the back to normal.
Remember to do the deep abdominal breathing at the end, repeat them once a day minimum and if you have any concerns just call your doctor or lymphoedema specialist.
Find out more about lymphoedema on the Cancer Research UK website.
More support and information
If you would like to talk to someone outside your own friends and family, you can phone the Cancer Research UK information nurses on freephone 0808 800 4040. The lines are open from 9am to 5pm, Monday to Friday.
You can also get in touch with organisations for people with head and neck cancer.
You can contact a local counsellor through your hospital or through one of the counselling organisations.