Paranasal sinus cancers are a group of heteroge­neous malignancies, which originate in proximity to vital structures. Close relation with orbit, cra­nial nerves, carotid arteries, and intracranial struc­tures including brain makes surgical resection highly critical with risk of serious morbidity. Relatively low incidence and heterogeneity ren­der randomized controlled trials regarding man­agement of these cancers difcult. Till the transition between the twentieth and the twenty­rst centuries, the operative procedures for para­nasal sinus cancers were mainly different types of maxillectomy, nasal cavity exenteration, exenter­ation of ethmoid cells, and exploration and curet­tage of sphenoid sinuses with an average 5-year survival rate of 28% [116]. In 1963, Ketcham etal. reported the craniofacial resection (CFR) for paranasal sinus cancers [117]. In the 1980s and 1990s, the craniofacial approach became the gold standard for sinus malignancies. Overall 5-year survival rate reported was around 51% except for olfactory neuroblastoma [118] (Fig.19.9).