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Table 18 Suggested CTV2 for ethmoid and maxillary sites

From: Technical guidelines for head and neck cancer IMRT on behalf of the Italian association of radiation oncology - head and neck working group

  Superior Inferior Lateral Posterior
Ethmoid Cribriform plate should be included. The inferior turbinate; In the case that the inferior border of the GTV allows a 10-mm margin around the original disease, the entire hard palate does not need to be included. The nasal cavity, ethmoid sinuses, and the ipsilateral maxillary sinus and when indicated the volume should extend to the rectus muscle. Include the sphenoid sinus. The retropharyngeal lymph nodes should be encompasses if the tumour extended close to the nasopharynx or if there are metastatic neck nodes from an ethmoidal carcinoma.
In the case it was been resected the margin should encompass all the initial GTV including the dura or the dural graft.
Maxillary The inferior border of the maxilla and the hard palate but should encompass a 10-mm margin around the initial GTV. Medial aspect should be the nasal septum, unless violation of midline structures occurs. The pterygopalatine and the infratemporal fossa should be included, paying special attention to encompass the masticator space and the infraorbital fissure.