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Rehabilitation and adjustment for nasal cavity and paranasal sinus cancer
Rehabilitation is an important part of cancer care. It helps you return to the activities of daily living after treatment for nasal cavity and paranasal sinus cancer.
Recovery is different for everyone. It depends on the stage of the disease, the type of treatment and many other factors. Your healthcare team will often start planning rehabilitation soon after diagnosis. This helps you learn what to expect and how to manage problems that may occur after treatment.
Talk to your healthcare team about the following as part of your rehabilitation.
Physiotherapy helps maintain or restore muscle strength and mobility. It can help people recover from treatments for cancer in the nasal cavity or paranasal sinuses.
Mouth-opening exercises should be done during and after radiation therapy. These exercises help strengthen the muscles used to open the mouth. Doing these exercises helps to prevent trismus, which is difficulty opening the jaw.
A radical neck dissection is a surgery to remove most of the lymph nodes from one side of the neck as well as the sternocleidomastoid muscle, accessory nerve and internal jugular vein. Removing the accessory nerve and sternocleidomastoid muscle can cause the shoulder on the side of the surgery to be lower than the shoulder on the other side of the body. This can lead to less mobility and pain if you don’t start physiotherapy as soon as possible after surgery. Strengthening exercises for shoulder and neck muscles can help balance the loss of the muscles.
Speech therapy and swallowing problems
Both surgery and radiation therapy for nasal cavity and paranasal sinus cancer can make swallowing difficult. They can also lead to speech problems. Speech therapy can help you to regain the ability to speak and swallow after these treatments.
A speech pathologist is a healthcare professional who helps manage speech and swallowing problems. You may see a speech pathologist before you begin treatment if your doctor thinks your treatment may lead to speech and swallowing problems. Meeting with you before treatment helps the speech pathologist figure out how to help you after treatment.
People who have had surgery to remove part or all of the upper jaw (called the maxilla) on one side of the head may have problems with food and liquids getting inside the nose when they eat. A speech therapist can suggest ways to help you swallow more easily, such as changes to posture, controlling the amount of food to be swallowed and exercises.
You may have special x-ray tests, such as an upper gastrointestinal (GI) series or video fluoroscopy, to see what happens when you swallow. This will help a speech therapist suggest ways to make swallowing safer and easier for you.
Loss of the sense of smell
Depending on the type of treatment given for nasal cavity and paranasal sinus cancer, some people can lose their sense of smell (called anosmia). Some people lose their sense of smell temporarily (for 3 or more months). In some cases, loss of the sense of smell can be permanent.
The olfactory cells in the mucosal lining of the nasal cavity make the sense of smell possible. Tumours can block air flow over the lining so that these cells can’t sense a smell as they normally would. Some types of surgery remove the lining, along with the olfactory cells. Other surgical procedures may damage the nerves responsible for smell (olfactory nerves). Some people will have their nose packed with gauze after surgery. During this time, they will not be able to smell anything. Radiation therapy can also directly damage the olfactory cells and nerves.
If you have anosmia, you will need to learn ways to cope without your sense of smell. You will need to be careful at home and work in case there is a chemical spill, fire or another harmful situation. It’s important to have working smoke detectors in your house and read labels on bottles of chemicals carefully as they may need to be used outside or in a well-ventilated area.
Changes to vision
Nasal cavity and paranasal sinus cancer that spreads to the eye or the bone and tissue around the eye (called the orbit) can cause vision changes. Some changes to vision are very minor. In some cases, doctors need to remove an eye to treat the cancer.
Loss of vision in an eye may make it hard to judge how far an object is away from you. As a result, you may bump into things on the side of the body where vision is affected. Your healthcare team may suggest exercises to help improve your ability to judge distance. People who have vision in one eye also may have problems driving at night.
It will take time to adjust to changes to vision. Get regular eye exams to check your vision.
Learn more about vision changes.
Changes to hearing
Radiation therapy and surgery for nasal cavity and paranasal sinus cancer may affect hearing. Hearing loss because of tissue swelling after surgery is usually temporary. Hearing loss after radiation therapy may be permanent.
Coping with hearing loss can be difficult. You may feel that it’s hard to have a conversation with someone in person or over the phone. You may also get tired of asking people to repeat themselves. It’s important that you tell people that you have trouble hearing and ask them to speak louder. You may also find it helpful to turn down a TV or radio to lower background noise when you’re having a conversation.
If your hearing changes, your doctor will refer you to a hearing specialist (called an audiologist). They will assess how much hearing loss you have and can provide hearing devices and suggest ways to help you cope.
Living with a tracheostomy
Some people may need to have a tracheostomy after treatment for nasal cavity and paranasal sinus cancer. A tracheostomy is a surgical procedure to create an opening (called a stoma) through the neck into the trachea (windpipe) to help a person breathe. A tube is placed through the stoma to create a new path for air to reach the lungs.
A tracheostomy may be done if you had reconstruction with a flap (a piece of tissue such as muscle, skin, fat or bone used to repair a surgical wound). For most people, a tracheostomy is temporary. It is used until your flap has healed and you can breathe normally through your nose and mouth.
Learn more about living with a tracheostomy.
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