KUMJ | VOL. 14 | NO. 4 | ISSUE 56 | OCT.-DEC. 2016
Variable Presentations of Sinonasal Polypoid Masses: A Tertiary Institution Experience
Dutta M, Ghatak S, Sen I, Sinha R
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.
Keyword : Histopathology, nasal obstruction, polypoid mass, presentation, sinonasal
