Unilateral sinonasal disease regarding clinical, radiological and pathological features

  • Said Mustafa Said Department of General Surgery, College of Medicine, Hawler Medical University, Erbil, Iraq.
  • Mahammad Sherwani Rizgary Teaching Hospital, Erbil, Iraq.
Keywords: Chronic rhinosinusitis, Unilateral nasal mass, Inflammatory nasal polyposis, Nasal obstruction

Abstract

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.

References

Kaplan BA, Kountakis SE. Diagnosis and pathology of unilateral maxillary sinus opacification with or without evidence of contralateral disease. Laryngoscope 2004; 114:981–5.

Suh JD, Chiu AG. Acute and Chronic Sinusitis. In: Lalwani AK, editor. Current Diagnosis and Treatment in Otolaryngology—Head & Neck Surgery. 3rded. New York: Lange McGraw Hills; 2008. P. 291–301.

Mohan B. Anatomy and Physiology of Nose and Paranasal Sinuses. In: Bansal M, editor. Diseases of Ear, Nose and Throat. New Delhi: Jaypee; 2013. P. 29–42.

Youngs R, Evans K, Watson M. The paranasal sinuses – a handbook of applied surgical anatomy. Taylor and Francis; 2006.

Jean M. Fungal rhinosinusitis. In: Hodder A. Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery. 7th ed. UK:Oxford, Blackwell Publishing; 2008. P. 1508–16.

Wolfgang D. Frontal sinus. In: Hodder A. Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery. 7th ed. UK: Oxford, Blackwell Publishing; 2008. P. 1500–25.

Martinduntiz SL. An Atlas of Imaging of the Paranasal Sinuses, The radiologic appearance of benign inflammatory paranasal sinus disease. 1st ed. London: Lippincott Williams & Wilkins; 1994. P. 87–110.

Gleeson MJ, Jones NS, Burton MJ, Clarke R, Browning G, Luxon N, et al, Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery. 7th ed. UK: Oxford, Blackwell Publishing; 2008. P. 1531–7.

Ah-See KW. Tumors of the nose and sinuses. In: Hussain SM, editor. Logan turner’s diseases of the nose, throat and ear, head and neck surgery. 11th ed. FL, USA: CRS press; 2016. P. 119–30.

Vivekananda S. Infectious rhinosinusitis. In: Bansal M, editor. Diseases of ear, nose and throat. New Delhi: Jaypee; 2013. P. 298–319.

Nair S, James E, Awasthi S, Nambiar S, Goyal S. A review of the clinicopathological and radiological features of unilateral nasal mass. Indian J Otolaryngol Head Neck Surg 2013; 65(Suppl 2):199–204.

Lee JY, Kim HK. Primary olfactory neuroblastoma originating from the inferior meatus of the nasal cavity. Am J Otolaryngology 2007; 28:196–200.

Lee JY. Unilateral paranasal sinus diseases. Acta Otolaryngological 2008; 128:621–6.

Salami A. Unilateral Sinonasal Disease: analysis of the clinical, radiological and pathological features. Journal faculty Med Baghdad 2009; 5:372–5.

Tritt S, McMains KC, Kountakis SE. Unilateral nasal polyposis: clinical presentation and pathology. Am J Otolaryngology, Head Neck Med Surgery 2008; 29:230–2.

Yoon JH, Na DG, Byun HS, Koh YH, Chung SK, Dong HJ. Calcification in chronic maxillary sinusitis: comparison of CT findings with histopathologic results. AJNR Am J Neuroradiology 1999; 20:571–4.

Chen CM, Su IH, Yew KN. Unilateral paranasal sinusitis detected by routine computed tomography: Analysis of pathology and image findings.J Radiol Sci 2011; 36:99–102.

Raveena R, Mahesh SG, Devan PP. A Retrospective Analysis of Sinonasal Masses: A Clinical, Histopathological and Radiological Correlation. IJSR 2015; 4(11):46–8.

Published
2020-04-30
How to Cite
Said, S., & Sherwani, M. (2020). Unilateral sinonasal disease regarding clinical, radiological and pathological features. Zanco Journal of Medical Sciences (Zanco J Med Sci), 24(1), 89-95. https://doi.org/10.15218/zjms.2020.012
Section
Original Articles