Sinonasal neoplasms often involve the anterior cranial base. Squamous cell carcinoma (SCC) accounts for up to 60% of cases. Tumors of the nasal fossae reach the ethmoid complex cranially, and involve the maxillary sinus, and orbits laterally. Tumors in the upper portion of the nasal cavity and ethmoid cells involve the cribriform plate, lamina papyracea, ethmoid roof, anterior cranial fossa, and brain. Ethmoidal tumors laterally affect the optic canal and orbital content through the lamina papyracea, and cranially the frontal sinus and anterior cranial fossa. Staging denotes prognosis but the therapeutic decision considers many other factors; this includes characteristics inherent to the tumor, the patient and their expectations, and also the experience of the surgeon and the available infrastructure.