Clinicopathological study of sino-nasal masses

Abstract

Background: There are few publications on sino-nasal masses from among the Indian population. Objective: To study clinico-pathological profile of sinonasal masses in the rural population in eastern India. Methods: A clinico-pathological study was conducted in the department of Otorhinolaryngology from January 2010 to October 2013 on 139 participants Results: In our series, presenting with sino-nasal masses (Males 85, Females 54; unilateral 107, bilateral 32) all cases presented with nasal obstruction; associated complaints were epistaxis 84(60.40%), rhinorrhoea 77(53.39%), epiphora 46(33.09%), hyposmia 42(30.21%), headache 38(27.30%), facial swelling 26(18.70%) and proptosis 5(3.59%). Leading site of origin was middle meatus (n=84) followed by lateral nasal wall (n=15) and nasopharynx (n=8). On histopathology, 95(68.34%) were non neoplastic and 44 (31.65%) were neoplastic leisons. Most common non-neoplastic lesion was allergic polyp (n=47) followed by inflammatory polyp (n=45). Amongst the neoplastic masses 34 were benign and 10 were malignant masses. Malignant tumors were squamous cell carcinoma (n=4), adenocarcinoma (n=2), one each of transitional cell carcinoma, plasmocytoma, rhabdomyosarcoma and esthesioneuroblastoma. Surgery was the principal mode of intervention. Benign masses were managed with standard Functional Endoscopic Sinus Surgery (FESS), Cald well luc and polypectomy (n=23), lateral rhinotomy and removal of mass (n=12), 6 cases of angiofibroma were treated with combined lateral rhinotomy and trans-palatal approach (n=3), single case of medial maxillectomy by lateral rhinotomy approach, transpalatal approach and endoscopic removal. Malignant tumors underwent maxillectomy by Weber Fergusson approach (n=7) and lateral rhinotomy (n=1) and medial maxillectomy (n=2) followed by radiotherapy. Conclusions: Sinonasal masses are fairly common with male predominance and malignancy increasing with age.