Clinical, Radiological and Histopathological Characteristics of Unilateral Sinonasal Lesions: An 8-Year Retrospective Study of 202 Patients

Öz

Unilateral sinonasal pathologies encompass a wide spectrum of conditions ranging from benign inflammatory lesions to rare malignancies, often posing diagnostic challenges due to their ability to mimic innocuous entities while potentially harboring aggressive disease. In this retrospective study conducted at a tertiary otorhinolaryngology center in southwestern Turkey, the epidemiological and histopathological characteristics of 202 adult patients who underwent surgical excision of unilateral sinonasal masses between January 2017 and January 2025 were analyzed. Patients with bilateral disease, previous biopsies at external centers, or incomplete medical records were excluded. The mean patient age was 48.1 ± 17.4 years, with a male predominance of 65.8%. The most prevalent diagnosis was inflammatory polyp or chronic inflammation (57.4%), followed by inverted papilloma (16.8%) and antrochoanal polyp (11.4%), while fungal pathologies, including allergic fungal rhinosinusitis and fungus ball, accounted for 6% of cases. Malignancies were identified in three patients (1.5%). Although computed tomography demonstrated bone erosion or destruction in 17.3% of cases, the majority of these lesions were benign. Nasal obstruction emerged as the most common presenting symptom, noted in 79.7% of patients. The findings emphasize that while most unilateral sinonasal pathologies are benign, the relatively high frequency of inverted papillomas and fungal lesions necessitates meticulous clinical and radiological assessment, with histopathological confirmation remaining indispensable for definitive diagnosis. These region-specific data offer valuable insight into the epidemiology of unilateral sinonasal pathologies and may inform future multicenter investigations aimed at enhancing diagnostic accuracy and treatment strategies.

Anahtar Kelimeler

• Inverted Papilloma
• Nasal Polyps
• Turkey
• Unilateral Nasal Obstruction

Proje Numarası

250094

Tek Taraflı Sinonazal Lezyonların Klinik, Radyolojik ve Histopatolojik Özellikleri: 202 Hastayı İçeren 8 Yıllık Retrospektif Çalışma

Öz

Tek taraflı sinonazal patolojiler, benign inflamatuar lezyonlardan nadir malignitelere kadar uzanan geniş bir hastalık spektrumunu kapsar ve masum görünümdeki kitlelerin altında agresif hastalıkların gizlenebilmesi nedeniyle tanısal açıdan güçlük oluşturabilir. Bu retrospektif çalışmada, Türkiye’nin güneybatısındaki üçüncü basamak bir otorinolarengoloji merkezinde Ocak 2017 ile Ocak 2025 tarihleri arasında tek taraflı sinonazal kitle nedeniyle cerrahi uygulanmış 202 erişkin hastanın epidemiyolojik ve histopatolojik özellikleri analiz edilmiştir. Bilateral hastalık, dış merkezde önceden yapılan biyopsi öyküsü veya eksik tıbbi kaydı olan hastalar çalışma dışı bırakılmıştır. Hastaların yaş ortalaması 48.1 ± 17.4 yıl olup, erkek hastaların oranı 65.8%’dir. En sık tanı inflamatuar polip ya da kronik inflamasyon (57.4%) olup, bunu inverted papillom (16.8%) ve antrokoanal polip (11.4%) izlemiştir. Alerjik fungal rinosinüzit ve fungus topu dahil olmak üzere fungal patolojiler 6% oranında saptanmıştır. Malignite üç hastada (1.5%) tespit edilmiştir. Bilgisayarlı tomografi, hastaların 17.3%’ünde kemik erozyonu veya destrüksiyonu göstermiş olsa da bu olguların büyük çoğunluğu benign karakterde bulunmuştur. En sık başvuru semptomu, hastaların 79.7%’sinde görülen nazal obstrüksiyondur. Bulgular, tek taraflı sinüs patolojilerinin büyük oranda benign olduğu izlenimini desteklemekle birlikte, özellikle inverted papillomlar ve fungal lezyonların kayda değer sıklığı, bu hastalık grubunun dikkatli klinik ve radyolojik değerlendirmesini gerekli kılmaktadır. Ancak, kesin tanı için histopatolojik doğrulama vazgeçilmezdir. Bölgeye özgü bu veriler, tek taraflı sinüs patolojilerinin epidemiyolojisine yönelik literatüre katkı sağlayabilir ve gelecekte yapılacak çok merkezli çalışmalara zemin oluşturabilir.

Anahtar Kelimeler

• İçeri Dönük Papillom
• Nazal Polipler
• Türkiye
• Tek Taraflı Nazal Obstrüksiyon

Proje Numarası

250094

Kaynakça

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