This presentation will review the complex anatomy of the paranasal sinuses with emphasis on the maxillary sinus. The diverse nature of the tumours of this region, surgical approaches and classification is discussed. Specific areas of controversy to be examined are the management of the neck, management of the globe/orbit, and the role of craniofacial resection. The presentation will also discuss the current emergence of primary reconstruction of the maxillectomy defect utilizing microvascular free flaps.