DO ROUTINE HISTOPATHOLOGICAL RESULTS SIGNIFICANT IN PATIENTS WITH APPLIED ENDOSCOPIC SURGERY FOR CHRONIC RHINOSINUSITIS?
1Ankara Üniversitesi, Kulak Burun Boğaz Hastalıkları A.B.D., Ankara, Türkiye2Gülhane Eğitim Araştırma Hastanesi, Kulak Burun Boğaz Hastalıkları, Ankara, Türkiye Aim: Aim of the study is to evaluate the radiological findings of patients undergoing endoscopic sinus surgery (ESS) with pre-diagnosis of chronic rhinosinusitis (CRS) with/without bilateral polyps, and to look at the correlation of the pre-diagnoses decided by evaluating their radiological findings with postoperative histopathological results and to determine the necessity of routine histopathological examinations in this group of patients.
Method: As a result of examinations and imaging, patients who underwent ESS between 2015 and 2020 with a preliminary diagnosis of CRS with or without polyps were included. Demographic characteristics of patients, preoperative endoscopic examination findings, radiological imaging findings, intraoperative findings and postoperative histopathological results were retrospectively evaluated.
Results: The Study included 299 patient. 145 unilateral and 154 bilateral ESS were performes. In histopathological examination in 154 patients with bilateral ESS, 84 (54.6%) patients had CRS with nasal polyps, 68 (44.2%) CRS without nasal polyps, 1 patient had antrochoanal polyp (ACP) and 1 fungal infection. Postoperative histopathological results of 145 patients with unilateral ESS are examined; it was observed that 84 (57.9%) patients had CRS without nasal polyps, 34 (23.6%) patients had CRS with nasal polyps and 15 (10.3%) had ACP. Also in 3 patients Inverted papilloma, in 2 patients carsinoma insitu and I in 1 patient metaplasia were detected. Sinonazal tumors were not detected in any of the patients who underwent bilateral ESS.
Result: With detailed examination and radiological examinations, largely sinonazal tumors can be excluded in paranazal sinus pathologies. Only mucosal lesions that may be precursors to malignancy, such as dysplasia, can be masked by KRS, which reduces the success of early diagnosis and treatment. However, in our study, the presence of these early stage lesions was found only in unilateral pathologies and at a low rate (insidental). This makes the necessity of routine histopathological examination especially after double-sided ESC debatable.
Keywords : Chronic Rhinosinusitis, Endoscopic Sinus Surgery, Paranasal Sinus Tumor