Clinicoepidemiological Presentation of Sinonasal Mass in A Nigerian Tertiary Health Care Centre

Abstract

Background: Sinonasal masses are common worldwide with clinical entity ranges from simple sinonasal polyps to malignancy. This study aimed at determining the prevalence, Sociodemographic features, clinical characteristics, clinical presentation, and management outcome of sinonasal masses. Materials and Methods: This was a retrospective study of patients with sinonasal masses in ear, nose and throat department of our center over a period of ten years (from November 2008 to October 2018). Data were retrieved from the clinic register and hospital medical record. Information on sociodemographic features, the clinical presentation of presentation, examination findings, CT Scan findings, diagnosis and treatment outcomes were retrieved. Data obtained were collated and analysed by using SPSS version 18.0. Results: The total number of patients seen over the studied period was 4,678 Male accounted for 62.9% with male to female ratio of 1.7:1. Sinonasal masses were bilateral in 44.3%, left-sided in 32.0% and right-sided in 23.7. Multiple grapelike sinonasal masses accounted for 50.5% while single sinonasal masses accounted for 49.5%. Commonest anatomical origin was ethmoid sinuses in 50.5%. Main clinical features were nasal blockage 83.5% and nasal discharge 63.9%. Masses extension was into 52.6% Intranasal/sinuses and 34.0% orbital extension. Main histological diagnosis were ethmoidal (simple) nasal polyps in 49.5%, squamous cell carcinoma in 17.5%, antrochoanal polyp in 9 3% and inverted papilloma in 9.3%. Histological examination showed simple inflammatory nasal polyps in 58.8%, benign tumour in 13.4% and malignant tumour in 23.7%. Patients were managed by 76.3% surgery, 16.5% surgery and radiotherapy and 7.2% chemoradiotherapy. Recurrent masses and death from malignancy were 8.2% and 2.1% respectively. Conclusions: Sinonasal masses are perceived and presented as a simple disorder with nasal obstructions and discharge. It consists of polyps and malignant tumour. Nasal Polyps are commoner than the neoplastic tumour. The commonest origin of the sinonasal masses was ethmoid sinuses which may be because polyps are the most common causes of sinonasal masses as shown in our study. Further evaluation revealed that majority of the unilateral sinonasal masses were neoplastic. They are poorly managed and presented in advanced stage to the otorhinolaryngologist, head and neck surgeon. Late presented patients had palliative treatment with resultant high recurrence and fatality. Thus Health education, serial and early screening are highly recommended.