Unilateral sinonasal disease regarding clinical, radiological and pathological features
Background and objective: Patient with unilateral nasal pathology is common in clinical practice. A careful history followed by complete otolaryngology examination is mandatory and diagnostic nasal endoscopy by either flexible or by using endoscope. This study aimed to assess patients presented with the unilateral sinonasal disease, regarding clinical features, CT scan findings, and histopathological results.
Methods: A prospective study was completed on 90 patients with unilateral sinonasal disease. The study was conducted at the Otolaryngology Department, Rizgary Teaching Hospital, Erbil city, Iraq, from February 2017 to July 2018. Regarding the pathological result, patients were categorized into two main groups of inflammatory and neoplastic. A biopsy was taken for histopathological confirmation from the patients with nasal mass either under local or under general anesthesia. The patients had been assessed clinically and radiologically.
Results: Chronic rhinosinusitis was found to be the commonest cause of unilateral sinonasal disease followed by antrochoanal Polyp, benign tumor, fungal sinusitis and then malignant tumor in that order. Male gender and right side were predominant. The purulent nasal discharge was the commonest symptom under inflammatory conditions, while nasal bleeding, dental and orbital complained were the main symptoms in neoplastic diseases. Calcifications were noted on CT scan, mainly in patients with fungal sinusitis. Bony erosion and destruction were detected in the malignant tumor.
Conclusion: Chronic rhinosinusitis was the most common cause of unilateral nasal and paranasal disease. Comprehensive evaluations of patient age, presenting symptoms, naso- endoscopic examination, and CT ﬁnding help in the diagnosis of unilateral sinus disease. However, histopathological confirmation remains the gold standard for final diagnosis.
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