Correlation of Preoperative Sinusitis Patients’ Characteristics with Final Diagnostic Findings
,
Abstract
Chronic rhinosinusitis (CRS) is a common disease which is usually diagnosed clinically, considering the combination of natural history, physical examination and imaging studies. This study aimed to evaluate the clinical value of routine postoperative histopathologic examination (POHE) in patients with a clinical diagnosis of chronic rhinosinusitis with polyposis (CRSWP), or without polyposis (CRSWOP One hundred of patients with clinically approved CRSWP and CRSWOP were enrolled in this study. All patients underwent complete physical examination, scoring paranasal sinuses involvement by Lund-Mackay (LM) CT scoring scale, determining the extent of polyposis by Stumberger's endoscopic classification, and assessing health related quality of life by Sinonasal Test 22 (SNOT22) questionnaire. After FESS, histopathologic results were compared with preoperative clinical diagnosis. Among our patients, 65% were male, and the rest of them were female. Also, 66% of them suffered from CRSWP, and the rest of them were CRSWOP. LM CT score and SNOT22 score was 36.62±12, 17.11±6, and 43.62±20 respectively. Only in one of patients with CRSWP, POHE was other than what was expected preoperatively (adenoid cystic carcinoma). In all other cases, POHE was well correlated with preoperative clinical diagnosis. HRQOL was better in males, absence of septal deviation and CRSWOP (P<0.05). Para nasal sinuses involvement in preoperative CT was more severe in the presence of eosinophil in POHE (P=0.008) and in patients with class 3 Stumberger's classification (P<0.001). This study suggested preoperative clinical diagnosis of CRS considering the combination of natural history, physical examination and imaging studies can be accurate, and POHE is indicated only in suspicious cases.
Meltzer EO, Hamilos DL. Rhinosinusitis diagnosis and management for the clinician: a synopsis of recent consensus guidelines. Mayo Clin Proc 2011;86(5):427-43.
Eccles, R., Mechanisms of the symptoms of rhinosinusitis. Rhinology 2011;49(2):131-8.
Marple BF, Stankiewicz JA, Baroody FM, Chow JM, Conley DB, Corey JP, Ferguson BJ, Kern RC, Lusk RP, Naclerio RM, Orlandi RR,Parker MJ. American Academy of Otolaryngic Allergy Working Group on ChronicmRhinosinusitis. Diagnosis and management of chronic rhinosinusitis in adults. Postgrad Med 2009;121(6):121-39.
Dudvarski Z, Janosević L, Pender I, Djukić V, Jesić S, Dimitrijević M, Arsović N. [Impact of rhinosinusal polyposis on CT score in patients with chronic rhinosinustis]. Vojnosanit Pregl 2010;67(3):209-12.
Basu S, Georgalas C, Kumar BN, Desai S. Correlation between symptoms and radiological findings in patients with chronic rhinosinusitis: an evaluation study using the Sinonasal Assessment Questionnaire and Lund-Mackay grading system. Eur Arch Otorhinolaryngol 2005;262(9):751-4.
Stankiewicz JA, Chow JM. Nasal endoscopy and the definition and diagnosis of chronic rhinosinusitis. Otolaryngol Head Neck Surg 2002;126(6):623-7.
Busaba NY, de Oliveira LV, Kieff DL. Correlation between preoperative clinical diagnosis and histopathological findings in patients with rhinosinusitis. Am J Rhinol 2005;19(2):153-7.
Romashko AA, Stankiewicz JA. Routine histopathology in uncomplicated sinus surgery: is it necessary? Otolaryngol Head Neck Surg 2005;132(3):407-12.
Arslan HH, Hidir Y, Durmaz A, Karslioglu Y, Tosun F, Gerek M. Unexpected tumor incidence in surgically removed unilateral and bilateral nasal polyps. J Craniofac Surg 2011;22(2):751-4.
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(4):321-3.
van den Boer C, Brutel G, de Vries N. Is routine histopathological examination of FESS material useful? Eur Arch Otorhinolaryngol 2010;267(3):381-4.
Diamantopoulos II, Jones NS, Lowe J. All nasal polyps need histological examination: an audit-based appraisal ofclinical practice. J Laryngol Otol 2000;114(10):755-9.
Dufour X, Bedier A, Ferrie JC, Gohler C, Klossek JM. Diffuse nasal polyposis and endonasal endoscopic surgery: long-term results, a 65-case study. Laryngoscope 2004;114(11):1982-7.
Hoseini SM, Saedi B, Aghazadeh K. Meticulous endoscopic sinus surgery to prevent recurrence of massive nasal polyposis. J Laryngol Otol 2012;126(8):789-94.
Ryan WR, Ramachandra T, Hwang PH. Correlations between symptoms, nasal endoscopy, and in-office computed tomography in post-surgical chronic rhinosinusitis patients. Laryngoscope 2011;121(3):674-8.
Hopkins C, Browne JP, Slack R, Lund V, Brown P. The Lund-Mackay staging system for chronic rhinosinusitis: how is it used and what does it predict? Otolaryngol Head Neck Surg 2007;137(4):555-61.
Gillett S, Hopkins C, Slack R, Browne JP. A pilot study of the SNOT 22 score in adults with no sinonasal disease. Clin Otolaryngol 2009;34(5):467-9.
Miłoński J, Zielińska-Bliźniewska H, Pietkiewicz P,Olszewski J. [Analysis of histopathological evaluation of pathological lesions removed by endoscopic surgery of the nose and paranasal sinuses in the own material]. Otolaryngol Pol 2011;65(6):447-50.
Baumann I, Blumenstock G, Zalaman IM, Praetorius M, Klingmann C, Sittel C, Plinkert PK, Piccirillo JF., Impact of gender, age, and comorbidities on quality of life in patients with chronic rhinosinusitis. Rhinology 2007;45(4):268-72.
Nair S, Dutta A, Rajagopalan R, Nambiar S., Endoscopic sinus surgery in chronic rhinosinusitis and nasal polyposis: a comparative study. Indian J Otolaryngol Head Neck Surg 2011;63(1):50-5.
| Files | ||
| Issue | Vol 51, No 8 (2013) | |
| Section | Articles | |
| Keywords | ||
| Sinusitis CT scan Pathology SNOT22 | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
