Evaluation of Unilateral Sinonasal Lesions

Background: Sinonasal lesions are a common occurrence in people of all ages. Nasal and paranasal sinus lesions are quite deceiving; Thus, the presenting characteristics, nasal endoscopy, clinical examination, histopathology, and radiographic findings are all used in conjunction to provide a diagnosis. The aim of this research was to observe a much of higher percentage of unilateral sinus pathology. Comprehensive evaluation of patient age, presenting symptoms, sex, nasoendoscopic examination and computed tomography (CT) or magnetic resonance imaging (MRI) results help in the diagnosis of unilateral sinus disease with finding the same result in patient who had endoscopic sinus surgery performed in ear, nose, and throat (ENT) department of Tanta University Hospital.

Methods: This prospective randomized controlled study was conducted on 100 adult and pediatric patients who were suffering from nasal obstruction, epistaxis, proptosis, headache, and space occupying lesions in one side of nose including inflammatory, benign and malignant lesions. All cases underwent complete taking of history, endoscopic assessment, otorhinogological examination, CT, MRI for evaluation of unilateral opacification of paranasal sinuses and other routine preoperative laboratory investigation.

Results: Of all affected sinuses, right maxillary sinus and nasal cavity were the most significantly affected sinuses in malignant tumor group than both inflammatory disease group and benign tumor group (P = 0.002, 0.001 respectively) while left maxillary, right ethmoid, left ethmoid, right sphenoid, left sphenoid, right frontal and left frontal showed insignificant differences in affection among the three groups. All performed radiology to the patients was insignificantly different among the three groups (P = 0.211). The main symptoms were significantly different among the three groups (P <0.001). Preoperative biopsy taking was significantly increased in malignant tumor group than both inflammatory disease and benign tumor group (P = 0.001). Diseases in the patients were significantly different among the three groups (P <0.001). Patients with excellent results of the operation was significantly decreased in malignant tumor group than benign tumor group (P = 0.001). The type of surgery was significantly different among the three groups (P <0.001).

Conclusions: Unilateral nasal polyps are associated with a high rate of malignancy and should be carefully examined using endoscopy and histology.