Clinico-pathological profile of sinonasal masses: an experience in national ear care center Kaduna, Nigeria (original) (raw)
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Clinico-pathological and radiological assessment of benign nasal masses
International Journal of Otorhinolaryngology and Head and Neck Surgery
A variety of neoplastic, non-neoplastic and inflammatory conditions involve the sinonasal cavity and these are encountered in day to day clinical practice. Incidence of these lesions is often stated to be between 1% and 4% of the population. 1 Sinonasal masses can be divided into two main categories: non neoplastic and neoplastic, which in turn are further divided into benign and malignant. Benign neoplasia of the nose and paranasal sinuses is relatively not uncommon. The benign nasal masses include nasal polypi, inverted papillomas, osteomas, haemangiomas, angiofibromas, meningocoel and meningoencephalocoele. The prevalence rate of nasal polyposis is about 2%. 2 Antrochoanal polyp is the most common choanal polyp arising from one of the paranasal sinuses. 3 Various pathologal events ranging from nonneoplastic to malignant sinonasal tumors may mimic a simple mass. Common causes of nasal obstruction are inflammatory polyps, with a prevalence of 4% in general population. 4 Benign tumors are relatively common, but malignant neoplasms are rare, relaying to 0.2-0.8% of all ABSTRACT Background: Sinonasal masses are uni or bilateral with variable and with multiple etiological factors. Benign masses are common in comparison to malignant in this region. Some of the benign masses e.g. juvenile angiofibroma and inverted papilloma cause local bony destruction. Preoperative radiological assessment is desirable for proper surgical Management. The purpose of the study was to assess the clinical and radiological findings of sinonasal masses and the correlation of the clinical and radiological findings with the histopathology. Methods: This prospective study was carried out on 50 cases if intra nasal masses. After clinical examination, these patients were subjected to radiology. The parameters assessed were the origin, extension, involvement of adjacent structure. Subsequently, all the cases were subjected to surgery i.e. polypectomy, medial maxillectomy, excision with the help of nasal endoscope. Thereafter, the histopathological findings were correlated with clinical and radiological findings. Results: Total 50 cases of intra nasal benign masses were included in the study. Among them 36 (72%) cases were of nasal polyps, out of which 29 (80.5%) were inflammatory polyps and 7 (19.4%) were allergic polyps. Among inflammatory polyps, 23 (79.3%) were males and 6 (20.69%) were females. Among allergic polyps 4 (57.14%) were males and 3 (42.85%) were females. The other findings were 5 (10%) cases of angiofibroma, 5 (10%) cases on inverted papilloma, 3 (6%) cases of haemangioma and 1 (2%) cases of chondrosarcoma. Conclusions: Considering the result obtained, the most common sinonasal lesions were inflammatory polyps. Others in order in order of frequency were allergic polyp, angiofibroma, inverted papilloma, haemangioma and chondrosarcoma.
CLINIC-PATHOLOGICAL PROFILE OF SINONASAL MASSES
A wide majority of lesions in the nose and the paranasal sinuses present as polypoidal mass in the nasal cavity. The Inflammatory conditions, infections, chronic rhino sinusitis, benign lesions and even malignancies can also present as nasal polyps. Early stage of malignancies in the nose is often misdiagnosed inadvertently. This is because malignancies too present as mass in the nose that mimics benign lesions and often associated with chronic rhino sinusitis. The present study was undertaken to know the clinic-pathological profile of sinonasal masses. The study group included 102 patients with nasal polypoidal masses, all patients were subjected to detailed history and clinical examination. All necessary investigations were done at greater accuracy. The final diagnosis was made after the histopathological examination of the excised masses. Depending on the final diagnosis, all masses were divided into non-neoplastic and neoplastic groups. Total 102 patients who presented with nasal polypoidal masses, of which 89 turned out to be non-neoplastic lesions and 13 were neoplastic, study showed that non-neoplastic lesions are very more common than neoplastic lesions. The Male patients were more prone to the formation of lesions when compared with non-neoplastic lesions. The nasal polyps were formed eighty-one percent. The study can found that, there is a high chance of discrepancy between the clinical and histopathological diagnosis.
A clinicopathological study of masses of nasal cavity paranasal sinuses and nasopharynx
International Journal of Otorhinolaryngology and Head and Neck Surgery, 2017
Background: A variety of inflammatory, non neoplastic and neoplastic masses involving nasal cavity, paranasal sinuses and nasopharynx are commonly encountered in ENT clinics. The objective was to study the demographic profile, clinical presentation, radiological findings and its correlation with the histopathological findings of masses of nasal cavity, paranasal sinuses and nasopharynx. Methods: The study was conducted on patients having sinonasal and nasopharyngeal masses admitted in dept of ENT, GMC, Patiala from August 2014 to July 2016. The study was designed to evaluate demographic distribution, clinicopathological features, radiological findings of sinonasal and nasopharyngeal masses and to evaluate the correlation of clinical and radiological findings with histopathological diagnosis. Results: Analysis of 50 cases of masses in nasal cavity, paranasal sinuses and nasopharynx was done. Male to female ratio was 1.38:1. The commonest site was nasal cavity followed by paranasal sinuses. Nasal polyp was the most common non-neoplastic lesion. Among the neoplastic lesions studied, inverted papilloma was the most common benign lesion and squamous cell carcinoma was the most common malignant lesion observed. Conclusions: For proper evaluation of sinonasal and nasopharyngeal masses, clinical, radiological and histopathological evaluation should be done in all patients. Although radiology provides a road map to endoscopic surgeons for any existing or impending complications but histopathology always gives a confirmatory diagnosis.
International Journal of Otorhinolaryngology and Head and Neck Surgery
Background: Purpose of study was to evaluate clinical, radiological, pathological correlation of sinonasal masses, to correlate age and sex with etiology of sinonasal masses and to evaluate percentage of patient having malignancy.Methods: This was a hospital based prospective observational study. In this study total numbers of 69 cases of sinonasal mass were selected from those patients who were admitted in department of otorhinolaryngology and head and neck surgery SAMC and PGI Indore MP from June 2019 to August 2021.Results: Sinonasal masses are more common in 4th to 6th decade, males, farmers and lower socioeconomic status. Most common presented symptom with sinonasal mass was nasal obstruction. Patients shows polypoidal mass in nasal endoscopy, which was most common finding. Most of the patients radiological scan shows the opacity. 26.1% cases were neoplastic and rest non neoplastic. These rules however, may be broken in sinonasal imaging. The relative number of non-neoplastic a...
Patterns, Presentations and Prognosis of Nasal Polyps
Indian Journal of Otolaryngology and Head & Neck Surgery, 2017
Few studies have documented the characteristic features of nasal polyps in the developing countries. In this study, we described the patterns, presentations and prognosis of nasal polyps seen in clinical setting, with a view to improve our understanding of its clinical and epidemiological characteristics. The study was a 10-year retrospective analysis of histologically-confirmed nasal polyps seen between January 2006 and December 2015. Records of patients with intranasal masses were retrieved from our hospital’s records department, clinics, wards and theatre suites. Those with nasal polyps were recruited into the study. The results were descriptively analyzed using SPSS statistical soft ware package version 10. There were 84 patients with intranasal masses seen within the reviewed period. Of this, 52 (61.9%) were histologically-confirmed nasal polyps. There were 22 males and 30 females. Their age ranges from 16 to 69 years. The most frequent symptom is nasal obstruction occurring in 76.9% of the cases. None of the patients had epistaxis. Thirty-one (59.6%) were associated with various complications either singly or multiple (Table 1). All (100%) were treated with conventional forceps excision. Eleven (21.2%) of them had recurrence between 3 and 5 years after surgery. None of the polyps or their recurrence exhibited malignant transformation. Nasal polyp is the most common intranasal mass seen in clinical practice. Its rarity in children and propensity for recurrence are reaffirmed. Although, recurrence is a major prognostic challenge, nasal polyp does not exhibit malignant transformation.Table 1Showing frequency distribution of the presenting complaints, radiological findings and complicationsVariableFrequency% Presenting complaints Nasal obstruction4076.9 Snoring3261.5 Visible nasal mass2548.1 Nasal discharge (watery, mucous, purulent)1426.9 Paroxysmal sneezing1019.2 Loss of sense of smell917.3 Headache815.4 Facial pain59.6Radiological findings Opacification of ethmoid and maxillary sinuses4688.5 Soft tissue opacity in the nasal cavity4178.9 Soft tissue opacity in the nasopharynx2650.0 Dome-shaped soft tissue opacity in the maxillary sinus1223.1 Fluid level in the maxillary sinus611.5 Clear paranasal sinuses47.7Complications Acute rhinosinusitis59.6 Epiphora611.5 Anosmia917.3 Obstructive sleep apnoea2853.8Open in a separate windowSome patients have multiple complaints/radiological findings/complications
Histomorphological Study of Benign Nasal Masses – a Five Year Study
2018
Non-neoplastic and neoplastic lesions of nasal cavity, paranasal sinuses and nasopharynx presents as either polypoidal mass or irregular mass. The lesions affects up to 4% of the population, commonly seen in middle aged males. 1,2 Nasal polyps are the projections of mucous membrane covered by columnar to ciliated epithelium and extends into the nasal Address of Correspondence: Dr Shashikala P Professor & Head, Department of Pathology S. S. Institute of Medical Sciences & Research Centre, Davangere Email:shashikalakrishnamurthy16@gmail.com cavity, paranasal sinuses or nasopharynx. 3
Clinico-pathological spectrum of sinonasal masses: a tertiary care hospital experience
International Journal of Otorhinolaryngology and Head and Neck Surgery
INTRODUCTION Sinonasal masses (SNM) are a fairly common clinical entity that occurs amongst patients of all age groups and are encountered routinely in ENT outpatient departments. They encompass a very wide range of pathologies ranging from non-neoplastic to neoplastic in nature. 1 Their presenting features are diverse and depend upon the type, spread and extent of the primary disease. Accordingly, the patients may have nasal features (obstruction, discharge, nasal mass, epistaxis, smell abnormalities), features of oro-facial involvement (palatal or buccal swelling, loose teeth, facial pain and swelling), orbital features (epiphora, proptosis, diplopia), aural features (fullness, hearing impairement), and/or metastatic neck nodes. 2 These masses can be congenital or acquired. Congenital masses such as dermoid cysts, glioma and encephaloceles are predominantly midline swellings, and may present either intranasally or extranasally. 3,4 Acquired sinonasal masses can be inflammatory including allergic, traumatic, granulomatous or neoplastic (benign and malignant) in nature. 5 Aquired pathologies presenting with sinonasal ABSTRACT Background: Sinonasal masses (SNM) are a fairly common clinical entity that occurs amongst patients of all age groups. There symptoms and signs frequently overlap, hence a diagnostic dilemma exists. A correct diagnosis is prudent for instituting correct treatment and expecting recovery. The purpose of this retrospective analysis was to decipher and study the various pathologies that present as sinonasal masses. Methods: A retrospective analysis done on 80 patients of SNM who presented to the Department of ENT, Subharti Medical College and Hospital, Meerut from May 2016 to April 2017. Their biodata, clinical profile and histolopathological diagnosis were analyzed. Results: SNM were male predominant and were non-neoplastic in 53 cases (66.25%). Nasal obstruction was the most common presenting feature (71 cases, 88.75%). Nasal polyps are the most commonly encountered SNM. Nonneoplastic SNM were common in the age group of 11 to 40 years. Benign SNM were common during the 2 nd to 4 th decade of life, while malignant SNM were common from 5 th decade onwards. Conclusions: SNM constitute a very wide spectrum of differential diagnoses. They have a male predominance and majority are non-neoplastic. Nasal polyps are the most commonly encountered SNM, seen during 2 nd to 4 th decade of life, while squamous cell carcinoma is the most commonly encounterd malignancy, generally from 5 th decade onwards. Surgery is the treatment of choice.
Tropical Journal of Ophthalmology and Otolaryngology, 2017
Introduction: Polypoidal mass in nose and paranasal sinuses are very common, that bulges or projects downwards from the normal nasal surface. The aim of the present study was to determine the incidence of nasal polypoidal mass and clinical and pathologic data of a group of consecutive cases. Materials and Methods: Clinico-pathological study of 92 consecutive cases of nasal polypoidal mass from single institution was performed for a period of 3 years. Clinical examination, routine investigations, Chest X ray PA were taken for all patients. Excised tissues were routinely processed for histopathologic examination. Results: Analysis of 92 polypoidal lesions in the nose and paranasal sinuses with clinical diagnosis of nasal polyps, revealed 52 cases were non-neoplastic and 40 were neoplastic; 34 (85%) were benign and 6 (15%) were malignant. True nasal polyps both inflammatory and allergic together comprised 49 cases of the 52 polypoidal lesions in the nasal cavity. Angiofibroma and capillary hemangioma were the most frequent benign tumour accounting for 30/34 (44%). The most common malignant tumour was squamous cell carcinoma 5/6 (83.3%). Conclusion: Majority of polypoidal mass in the nasal cavity were non-neoplastic, with histopathological examination being the easiest method for identification and distinguishing the type of sinonasalpolypoidal masses.
Observation of various symptoms of non-neoplastic nasal mass in ent
International journal of health sciences
Tumors in the nasal cavity and paranasal sinuses were recognized during the time of Hippocrates. Whillis (1948) defined tumors as “an abnormal mass of tissue, the growth of which exceeds and is coordinated with that of the normal tissues and persists in the same excessive manner after cessation of the stimuli which evoked the Change” From the table I it is evident that only 5 cases of malignant and 3 cases of fungal Granuloma, there was bony erosion. In 19 cases of antro chonal polyp and antrum and ethmoid sinus is found to be hazy. From the table I, on radiological study, sinuses are found to be hazy in 86.4% cases of antro choanal polyp and 89.4% cases of ethmoidal polyp. This finding is in accordance with that of miles (1971) who started that usually there is some degree of opacity of sinuses either due to thickening of mucosa or superadded infection. erosion of bone is found in 70% cases of malignancy and the 3 case of fungal granuloma.
Uncommon and Atypical Sinonasal Masses: Diagnostic and Therapeutic Challenges
An International Journal Clinical Rhinology, 2012
Introduction Sinonasal masses are a wide range of pathologies ranging from simple nasal polyps to rare tumors like esthesioneuroblastomas. Early symptoms of all of them are similar to common nasal and sinus problems, hence, producing a delay in diagnosis. Materials and methods All the patients presenting with sinonasal masses in the Department of ENT and Head/Neck Surgery, SRMS Institute of Medical Sciences, Bareilly, were included in the study. The study was carried out between January 2007 and December 2011. Detailed history and ENT examination were recorded. Radiological investigation was carried out in the form of computed tomographic (CT) scan of nose and paranasal sinuses. Final diagnosis was made by histopathological examination either before instituting any form of treatment or by a postsurgical biopsy where surgery was carried out. Immunohistochemistry was done in some cases as deemed necessary by the pathologist. Thus, their modes of presentation, radiological and histopat...