Role of histopathological and microbiological investigations for a definitive diagnosis of benign sinonasal masses: a tertiary care institute study

Arvinder Singh Maan; Ruchika Bhagat; Navneet

doi:10.18203/2320-6012.ijrms20240516

Authors

Arvinder Singh Maan Department of ENT, Govt. Medical College, Amritsar, Punjab, India
Ruchika Bhagat Department of ENT, Dr B. R. Ambedkar Institute of Medical Sciences, Mohali, Punjab, India
Navneet Department of ENT, Govt. Medical College, Amritsar, Punjab, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20240516

Keywords:

Sino-nasal masses, Contrast enhanced computed tomography, Histopathological examination, Computed tomography, Diagnostic nasal endoscopy, Non-invasive fungal sinusitis

Abstract

Background: This research aimed to study the clinical presentation of various sino nasal masses (SNM), to study the importance of Histopathological and microbiological investigations in making diagnosis of SNM and to study the correlation between clinical, radiological, histopathological, and microbiological findings of SNM.

Methods: In the present study 50 patients attending the ENT outpatient department with clinical evidence of nasal mass were selected based on inclusion and exclusion criteria. Patients were examined clinically and radiologically followed by surgical intervention. Histopathological and microbiological examination was done to make a definitive diagnosis.

Results: Majority of cases were from 21-40 years age group (66%) with male preponderance. Nasal obstruction was most common symptom 45 (90%) followed by nasal discharge 43(86%). On histopathology highest incidence was of inflammatory polyps 22 (44%) followed by allergic polyps 14(28%) and non-invasive fungal sinusitis (NIFS) 11 (22%) respectively. Microscopically in KOH, fungal elements, yeast and hyphae were seen in total 11 (22%) cases and with SDA, Aspergillus niger was seen in 7 (14%) cases, Candida albicans in 3 (6%) and both in 1 (2%) case. Correlation of provisional diagnosis with HPE was found to be highly significant.

Conclusions: It was observed that histopathological and microbiological examination is irreplaceable as both are the “GOLD STANDARD” for making a definitive diagnosis.

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References

Somani S, Kamble P, Khadkear S. Mischievous presentation of nasal masses in rural areas. Asian J Ear Nose Throat. 2004;2:9-17.

Bateman N, Fahy C, Woolford T. Nasal polyps: still more questions than answers. J Laryngol. 2003;117:1-9.

Summerton N. The medical history as a diagnostic technology. Brit J Gene Pract. 2008;58(549):273-6.

Bhagat R, Maan AS, Sharma KK, Chander R. Combined radiological and endoscopic evaluation of sino nasal anatomical variations in patients of chronic rhinosinusitis: a North Indian Study. Ind J Otolaryngol Head Neck Surg. 2023:1-8.

Maheshwari A, Bansal A. Clinico-pathological spectrum of sinonasal masses: a tertiary care hospital experience. Int J Otorhinolaryngol Head Neck Surg. 2017;3(4):1015-9.

Sharma R, Sahni D, Uppal K, Gupta R, Singla G. A clinicopathological study of masses of nasal cavity, paranasal sinuses and nasopharynx. Int J Otorhinolaryngol Head Neck Surg. 2017;3(2):253-8.

Bakari A, Afolabi OA, Adoga AA, Kodiya AM, Ahmad BM. Clinico-pathological profile of sinonasal masses: an experience in national ear care center Kaduna, Nigeria. BMC Res Notes. 2010;3(1):186.

Zafar U, Khan N, Afroz N, Hasan SA. Clinicopathological study of non-neoplastic lesions of nasal cavity and paranasal sinuses. Ind J Pathol Microbiol. 2008;51(1):26.

Agarwal P, Panigrahi R. Sinonasal mass-a recent study of its clinicopathological profile. Ind J Surg Oncol. 2017;8(2):123-7.

Dafale SR, Yenni VV, Bannur HB, Malur PR, Hundgund BR, Patil SY. Histopathological study of polypoidal lesions of the nasal cavity-A cross sectional study. Al Ameen J Med Sci. 2012;5(4):403-6.

Bist SS, Varshney S, Baunthiyal V, Bhagat S, Kusum A. Clinico-pathological profile of sinonasal masses: An experience in tertiary care hospital of Uttarakhand. Nat J Maxillof Surg. 2012;3(2):180.

Gupta R, Moupachi SS, Poorey VK. Sinonasal masses: a retrospective analysis. Ind J Otolaryngol Head Neck Surg. 2013;65(1):52-6.

Lathi A, Syed MM, Kalakoti P, Qutub D, Kishve SP. Clinico-pathological profile of sinonasal masses: a study from a tertiary care hospital of India. Acta Otorhinolaryngol Ital. 2011;31(6):372.

Rehman AB, Rafiq FA, Uppal AA. Evaluation of allergic fungal sinusitis occurrence in patients with nasal polyps. Pak J Med Health Sci. 2015;9(3):875-8.

Budhiraja G, Mittal S, Kaur A, Gill AK, Suri V. A study of non-neoplastic nasal polypoidal lesions and its relation with local and systemic eosinophilia, peripheral IgE levels and mast cell quantitation. Sch J App Med Sci. 2017;5(6B):2108-16.

Varshney H, Varshney J, Biswas S, Ghosh SK. Importance of CT scan of paranasal sinuses in the evaluation of the anatomical findings in patients suffering from sinonasal polyposis. Ind J Otolaryngo Head Neck Surg. 2016;68(2):167-72.

Shahizon AMM, Suraya A, Rozman Z, Aini AA, Gendeh BS. Correlation of computed tomography and nasal endoscopic findings in chronic rhinosinusitis. Med J Malay 2008;63(3):211-5

Fadda GL, Succo G, Moretto P, Veltri A, Castelnuovo P, Bignami M, et al. Endoscopic endonasal surgery for sinus fungus balls: clinical, radiological, histopathological, and microbiological analysis of 40 cases and review of the literature. Iran J Otorhinolaryngol. 2019;31(102):35.

Kale SU, Mohite U, Rowlands D, Drake-Lee AB. Clinical and histopathological correlation of nasal polyps: are there any surprises? Clin Otolaryngol All Sci. 2001;26(4):321-3.

Diamantopoulos I, Jones N, Lowe J. All nasal polyps need histological examination: an audit-based appraisal of clinical practice. J Laryngol Otol. 2000;114(10):755-9.