Unilateral sinonasal surgery: analysis of symptoms and pathologic diagnoses

Yıl 2019, , 346 - 351, 29.08.2019

Nurdoğan Ata

https://doi.org/10.35440/hutfd.541138

Öz

Background: The aim of the study is to analyze the
clinical symptoms and histopathologic diagnoses of patients with unilateral
sinonasal symptoms who have been operated on in our clinic.

Methods: We performed a retrospective review of the
medical records of 54 patients with unilateral sinus disease who underwent
surgical intervention and had pathological specimens between June 2013 and May
2017. Presenting symptoms, medical histories, and previous treatments were
analyzed.

Results: Fifty-four patients were diagnosed
pathologically by endoscopic sinonasal surgery. In 40 of the patients
non-tumoral pathologies were stabbed and in 14 patients tumoral pathology was
detected. Of the non-tumoral lesions, 29 patients had chronic sinusitis-nasal
polyps, 5 patients had isolated inferior turbinate mulberry hypertrophy, 3
patients had rhinolitis, 2 patients had mucocele, and 1 patient had accessory
middle turbinate. In tumoral pathologies, 6 patients had hemangiomas, 5
patients had inverted papillomas, 2 patients had osteomas and 1 patient had
malignant melanomas. Epistaxis was more frequently detected in tumoral
pathologies, while the most frequent cause was nasal obstruction.

Conclusion: Although the majority of unilateral sinonasal
pathologies are benign lesions, tumoral pathologies are more common than
bilateral diseases. An important finding in our study is that inferior
turbinate mulberry hypertrophy and nasal hemangiomas are not uncommon and
constitute a significant part of unilateral nasal lesions.

Tek taraflı sinonazal cerrahi: semptomlar ve patolojik tanıların analizi

Öz

Amaç: Çalışmanın amacı tek taraflı sinonazal
semptomlarla başvuran ve opere edilen hastaların klinik semptom ve
histopatolojik tanılarını analiz etmektir.

Materyal
ve Metot:
Haziran 2013- Mayıs 2017 tarihleri arasında ikinci basamak tek merkezde tek
taraflı sinonazal hastalık nedeniyle opere edilen ve patolojik tanısı bulunan
54 hastanın dosyaları retrospektif analiz edildi. Hastaların başvuru
şikayetleri ve histopatolojik tanıları analiz edildi.

Bulgular: Elli dört hastanın tamamına endoskopik
sinonazal cerrahi uygulandı. Hastaların 40’ında tümöral olmayan patolojiler
saplanırken 14 hastada tümöral patoloji saptandı. Tümöral olmayan lezyonlardan
29 hastada kronik sinüzit- nazal polip, 5 hastada izole alt konka mulberry
hipertrofisi, 3 hastada rinolit, 2 hastada mukosel, 1 hastada ise aksesuar orta
konka tespit edildi. Tümöral patolojilerden 6 hastada hemanjiom, 5 hastada
inverted papillom, 2 hastada osteom ve 1 hastada malign melanom tespit edildi.
En sık görülen başvuru nedeni burun tıkanıklığı iken, tümöral patolojilerde
epistaksis daha sık tespit edildi.

Sonuç: Tek taraflı sinonazal patolojilerin
çoğunluğunu benign lezyonlar oluşturmasına rağmen tümöral patolojiler iki
taraflı hastalıklara göre daha yaygındır. Bizim çalışmamızda önemli bir bulgu
alt konka mulberry hipertrofisi ve nazal hemanjiomların nadir görülmeyip tek
taraflı nazal lezyonların önemli bir kısmını oluşturmasıdır.

 

Anahtar Kelimeler

Tek taraflı sinonazal hastalık, endoskopi, polip, burun tıkanıklığı

Kaynakça

• Lee JY. Unilateral paranasal sinus diseases: analysis of the clinical characteristics, diagnosis, pathology, and computed tomography findings. Acta Otolaryngol. 2008; 128:621.
• Tritt S, McMains KC, Kountakis SE. Unilateral nasal polyposis: clinical presentation and pathology. Am J Otolaryngol. 2008;29(4):230-2.
• Ikeda K, Tanno N, Suzuki H, et al. Unilateral sinonasal disease without bone destruction. Differential diagnosis using diagnostic imaging and endonasal endoscopic biopsy. Arch Otolaryngol Head Neck Surg 1997;123:198Y200
• Habesoglu TE, Habesoglu M, Surmeli M, et al. Unilateral sinonasal symptoms. J Craniofac Surg. 2010; 21:2019–2022.
• Belli S., Yildirim M., Eroglu S., Kaya Emre F. Single-sided sinonasal mass: A retrospective study. North Clin Istanb 2018;5(2):139–1436
• Habesoglu TE, Habesoglu M, Surmeli M, Uresin T, Egeli E. Unilateral sinonasal symptoms. J Craniofac Surg. 2010;21(6):2019-22.
• Paz Silva M, Pinto JM, Corey JP, Mhoon EE, Baroody FM, Naclerio RM. Diagnostic algorithm for unilateral sinus disease: a 15-year retrospective review. Int Forum Allergy Rhinol 2015;5:590–6.
• Rudralingam M, Jones K, Woolford TJ. The unilateral opaque maxillary sinus on computed tomography. Br J Oral Maxillofac Surg 2002;40:504-79
• Tritt S, McMains KC, Kountakis SE. Unilateral nasal polyposis: clinical presentation and pathology. Am J Otolaryngol. 2008;29:230-232
• Ata N. Complete Mulberry Hypertrophy and Conchachoanal Polyp of Inferior Turbinate.J Craniofac Surg. 2015 Nov;26(8):e799.
• Wallner LJ. Allergy as the cause of mulberry hypertrophy of the inferior turbinate. Ann Allergy 1949; 7 (2): 258-65.
• Akduman D, Karaman M, Aydin E ,et al. Coincidence of conchachoanal polyp and mulberry hypertrophy of inferior concha. Laryngoscope 2009; 119 (4): 762-4.
• Christmas DA, Mirante JP, Yanagisawa E. Endoscopic view of ‘mulberry hypertrophy' of the inferior turbinates. Ear Nose Throat J 2005; 84 (10): 622-3.
• Akduman D, Haksever M, Yanilmaz M, Solmaz F. Mulberry hypertrophy and accompanying sinonasal pathologies: A review of 68 cases.Ear Nose Throat J. 2016 Aug;95(8):E1-7.