Clinicopathological Profile of Patients with Unilateral Sinonasal Masses in Karbala


background: A variety of non-neoplastic and neoplastic conditions involving the nasal cavity, paranasal sinuses, and nasopharynx. Most patients present with complaints of nasal obstruction. Other symptoms include nasal discharge, epistaxis, and disturbances of smell, oral symptoms, facial swelling, orbital symptoms, and ear symptoms. The presence of unilateral symptoms or pathology is regarded with caution as sinonasal neoplasms which may also present during their early stages with subtle symptoms that mimic an inflammatory pathology.Objectives: The aim of the study was to analyze the histopathologic diagnosis of patients with unilateral nasal mass and identify their different clinical presentations.Methods: A cross sectional prospective study was carried out on 34 consecutive patients with unilateral sinonasal mass at Al-Hussein Teaching Hospital and Maythem Al-Tammar Private Hospital, Karbala between April to August 2015 focusing on patient’s age, sex, and complaints. . Clinical examinations and proper investigations were carried out for all patients. Biopsy was taken from all cases for histopathologic examination to confirm diagnosis.Results: Out of total 34 patients with unilateral sinonasal masses 25 (73.5%) were males and 9 (26.5%) were females (M: F=2.8:1). The age range was 7 to 60 years with a mean age of 29.2 years. Twenty two patients were found to have non-neoplastic unilateral conditions (64.7%), while 12 patients had neoplastic unilateral conditions (35.3%). Inflammatory nasal polyp was the most common condition in non-neoplastic group (59.9%). Inverted papilloma was the commonest benign neoplastic condition (17.7%), 3 cases of non-Hodgkin’s lymphomas (8.9%) represents the commonest malignant neoplasms among malignant neoplastic group and single case of adenoid cystic carcinoma.Conclusions: Sinonasal masses have various differential diagnoses that otolaryngologists have to consider this variability in diagnosis and treatment. Nasal obstruction is the most common symptom while epistaxis and extranasal symptoms like facial pain, dental and orbital complaints were found to be higher in the neoplastic conditions. The clinician must have a high index of suspicion to rule out a neoplastic etiology in all cases of unilateral nasal mass.