Histopathological analysis in functional endoscopic sinus surgery

Year 2023, Volume: 4 Issue: 4, 306 - 310, 30.08.2023

Süheyla Kandemir , Tuba Yiğit Gözde Pamuk

https://doi.org/10.47582/jompac.1299694

Abstract

Aim: The aim of this study is to determine the histopathological diagnosis distribution and benign-malignant ratios of patients who have undergone functional endoscopic sinus surgery (FESS).
Material and Methods: The pathology results of patients who underwent FESS in our clinic between 2018 and 2022 were retrospectively scanned from the hospital database. Demographic characteristics (age, gender) and histopathological findings in the files of the patients were recorded. Histopathological diagnosis distributions and benign-malignant ratios were determined.
Results: A total of 365 patients (262 men (71.8%) and 103 women (28.2%)) were retrospectively scanned from the hospital database. The mean age of the patients was 40.09±13.79 (Mean±SD). The most common histopathological diagnoses were nasal polyp (76.4%), chronic inflammation, edema and congestion (Chronic sinusitis) (16.7%), respectively. Among the malignant tumors, squamous cell carcinoma (0.8%) was observed. Inverted papillomas, which are likely to transform into malignancy, were observed at a rate of 1.0%. Considering the histopathological diagnosis distribution by gender, there was no statistically significant difference (p>0.05). Considering the histopathological diagnosis distribution by age, there was a statistically significant difference (p=0.01). Malignant pathologies were seen in advanced ages.
Conclusion: The most common histopathological result in patients undergoing FESS is non-neoplastic lesions. However, unexpected malignancy diagnoses are encountered, albeit in a small number. Therefore, routine histopathology of FESS is essential to identify pathologies with different prognosis.

Keywords

paranasal sinuses, endoscopy, pathology, nasal polyps, paranasal sinus neoplasm

Supporting Institution

Yok

Project Number

Yok

Histopathological analysis in functional endoscopic sinus surgery

Abstract

Aims: The aim of this study is to determine the histopathological diagnosis distribution and benign-malignant ratios of patients who have undergone functional endoscopic sinus surgery (FESS).
Methods: The pathology results of patients who underwent FESS in our clinic between 2018 and 2022 were retrospectively scanned from the hospital database. Demographic characteristics (age, gender) and histopathological findings in the files of the patients were recorded. Histopathological diagnosis distributions and benign-malignant ratios were determined.
Results: A total of 365 patients (262 men (71.8%) and 103 women (28.2%)) were retrospectively scanned from the hospital database. The mean age of the patients was 40.09±13.79 (Mean±SD). The most common histopathological diagnoses were nasal polyp (76.4%), chronic inflammation, edema and congestion (Chronic sinusitis) (16.7%), respectively. Among the malignant tumors, squamous cell carcinoma (0.8%) was observed. Inverted papillomas, which are likely to transform into malignancy, were observed at a rate of 1.0%. Considering the histopathological diagnosis distribution by gender, there was no statistically significant difference (p>0.05). Considering the histopathological diagnosis distribution by age, there was a statistically significant difference (p=0.01). Malignant pathologies were seen in advanced ages.
Conclusion: The most common histopathological result in patients undergoing FESS is non-neoplastic lesions. However, malignancy diagnoses are encountered, albeit in a small number. Therefore, routine histopathology of FESS is essential to identify pathologies with different prognosis.

Keywords

paranasal sinuses, endoscopy, pathology, nasal polyps, paranasal sinus neoplasm

Project Number

Yok

References

• Karakus MF, Ozcan KM, Ozcan M, Yuksel Y, Titiz A, Unal A. Changes in indications for endoscopic sinonasal surgery over 14 years. B-ENT. 2008;4:221-5.
• Stammberger H. Posawetz W. Functional endoscopic sinus surgery. Concept, indications and results of the Messerklinger technique. Eur Arch Otorhinolaryngol. 1990;247:63-76.
• Watelet JB, Annicq B, van Cauwenberge P, Bachert C. Objective outcome after functional endoscopic sinus surgery: Prediction factors. Laryngoscope. 2004;114:1092–7.
• Jiang RS, and Hsu CY. Functional endoscopic sinus surgery in children and adults. Ann Otol Rhinol Laryngol. 2000;109:1113–6.
• Toros SZ, Bölükbasi S, Naiboğlu B, et al. Comparative outcomes of endoscopic sinus surgery in patients with chronic sinusitis and nasal polyps. Eur Arch Otorhinolaryngol. 2007;264:1003–8.
• Lund VJ, Stammberger H, Nicolai P, et al. European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol Suppl. 2010;22:1–143.
• Von Buchwald C, Bradley PJ. Risks of malignancy in inverted papilloma of the nose and paranasal sinuses. Curr Opin Otolaryngol Head Neck Surg. 2007;15:95–8.
• Norlander T, Frödin JE, Silfverswärd C, Anggård A. Decreasing incidence of malignant tumors of the paranasal sinuses in Sweden. An analysis of 141 consecutive cases at Karolinska Hospital from 1960 to 1980. Ann Otol Rhinol Laryngol. 2003;112:236–41.
• de Almeida JR, Su SY, Koutourousiou M, et al. Endonasal endoscopic surgery for squamous cell carcinoma of the sinonasal cavities and skull base: oncologic outcomes based on treatment strategy and tumor etiology. Head Neck. 2015;37:1163–9.
• König M, Osnes TA, Lobmaier I, et al. Multimodal treatment of craniofacial osteosarcoma with high-grade histology. A single-center experience over 35 years. Neurosurg Rev. 2017;40:449–60.
• König M, Osnes T, Jebsen P, Meling TR. Craniofacial resection of malignant tumors of the anterior skull base: a case series and a systematic review. Acta Neurochir (Wien). 2018;160:2339–48.
• Ghogomu N. Kern R. Chronic rhinosinusitis: the rationale for current treatments. Expert Rev Clin Immunol. 2017;13:259-70.
• Wong JS, Hoffbauer S, Yeh DH, Rotenberg B, Gupta M, Sommer DD. The usefulness of routine histopathology of bilateral nasal polyps - a systematic review, meta-analysis, and cost evaluation. J Otolaryngol Head Neck Surg. 2015;4:44-6
• van den Boer C, Brutel G, de Vries N. Is routine histopathological examination of FESS material useful? Eur Arch Otorhinolaryngol. 2010;267:381-4.
• Yaman H, Alkan N, Yilmaz S, Koc S, Belada A. Is routine histopathological analysis of nasal polyposis specimens necessary? Eur Arch Otorhinolaryngol. 2011;268:1013-5.
• Garavello W, Gaini RM. Histopathology of routine nasal polypectomy specimens: a review of 2,147 cases. Laryngoscope. 2005;115:1866-8.
• Diamantopoulos II, Jones NS, Lowe J. All nasal polyps need histological examination: an audit-based appraisal of clinical practice. J Laryngol Otol. 2000;114:755–9.
• Romashko AA, Stankiewicz JA. Routine histopathology in uncomplicated sinus surgery: is it necessary? Otolaryngol Head Neck Surg. 2005;132:407–12.
• Kale SU, Mohite U, Rowlands D, Drake-Lee AB. Clinical and histopathological correlation of nasal polyps: are there any surprises? Clin Otolaryngol Allied Sci. 2001;26:321–3.
• Govindaraj S, Wang H. Does human papilloma virus play a role in sinonasal inverted papilloma? Curr Opin Otolaryngol Head Neck Surg. 2014;22:47–51.
• Lisan Q, Laccourreye O, Bonfils P. Sinonasal inverted papilloma: from diagnosis to treatment. Eur Ann Otorhinolaryngol Head Neck Dis. 2016;133:337-41.