Publication: Variable Presentations of Sinonasal Polypoid Masses: A Tertiary Institution Experience
Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Lesions of the sinonasal area are varied, but they mostly present as polypoid masses
which require meticulous work-up to reach at the most probable diagnosis.
Objective
Analysis of polypoid sinonasal masses in terms of etiology, clinical presentations,
brief demographic profile, clinico-histologic correlate where possible, and follow-up
results.
Method
In this descriptive, longitudinal study, 198 patients with polypoid sinonasal masses
attending the otolaryngology clinic of a tertiary teaching institute were selected using
proper selection criteria and analyzed through a pre-set proforma and algorithm for
a diagnostic work-up (that included histopathology where necessary).
Result
Common presentations were nasal obstruction (~89%), discharge (~70%) and
hyposmia (~22%). Though nearly 87% was clinically benign and 8% indeterminate,
therapeutic and diagnostic interventions (including histopathology) showed 91%
truly benign, of which polyposis formed the bulk. Sensitivity of clinical detection
was 75% for benign lesions and 62% for malignancies. Diagnosis depended on
histopathology in 52.52% cases, including the clinically malignant, the “grey zone”,
and more than 40% of the clinically benign lesions. There was male predilection
(2.16 for benign lesions and 1.57 for malignant), rural preponderance, and above
60% of the patients were within 50-70 years. There was ~26% recurrence in the
follow-up period of a minimum of one year, predominantly in polyposis (29.55%) and
malignancies (~39%).
Conclusion
Presentations of polypoid sinonasal masses are variable, etiology of which is mostly
benign. Proper clinico-histologic correlate is necessary for correct diagnosis. A low
threshold of suspicion is required because of this variability, necessitating follow-up
for further evaluation.
KEY WORDS
Histopathology, nasal obstruction, polypoid mass, presentation, sinonasal
Description
Dutta M,1 Ghatak S,2 Sen I,3 Sinha R1
1Department of ENT and Head - Neck Surgery
Medical College and Hospital
Kolkata, West Bengal, India.
2Department of ENT and Head-Neck Surgery
College of Medicine and Sagore Dutta Hospital
Kolkata, West Bengal, India.
3Department of ENT and Head-Neck Surgery
Midnapore Medical College and Hospital
Midnapore, West Bengal, India
Keywords
Histopathology, nasal obstruction, polypoid mass, presentation, sinonasal