Analysis Of The Clinical And Pathological Characteristics Of Sinonasal Neoplasms

As the important anatomy and physiology sites of the upper airway, Nasal cavity and sinuses can occur multiple types of tumors.Because of their age characteristics of pediatrics and elder, the incidence of these tumors has their own specificity. Sinonasal Inverted papilloma (NIP) are the most common benign sinonasal tumour that generate considerable interest because it is locally aggressive, has a tendency to recur,and are associated with malignancy.ObjectiveTo study the clinical and pathological characteristics of sinonasal tumors and have a comprehensive understanding of the clinical characteristics of neoplasms in pediatrics and elder.To explore the factors that influence the Prognosis. To study the recurrence rate and explore the factors associated with recurrence and evaluate the effects and difference of endoscopic surgery,endoscopic surgery combined with an external approach and traditional procedures in the treatment of sinonasal inverted papilloma, krouse classification of sinonasal inverted papilloma are given.MethodsA cohort of597patients confirmed by surgical pathological examination with sinonasal tumors were enrolled in this study. The clinicopathological characteristics,including age, sex, disease component ratio, and origination were retrospectively reviewed. These characteristics of hospitalized children and old patients were discussed separately.We give a follow-up to these patients,.Factors that influence its recurrece were Explored, and malignant characteristics were summarized。The follow-up results of NIP patients were analyzed retrospectively.ResultsIn this series of597patients of sinonasal neoplasms, the ratio between males and females was1.34:1. aged from2to84years, with a median of53years, there were334benign tumors and263malignant tumors.As for their origination,255neoplasms arose from the nasal cavity and342tumors derived from sinus, including171maxillary sinus tumors,56frontal sinus tumors,83ethmoid sinus tumors, and32sphenoidal sinus tumors. In the pediatrics series, the ratio between males and females was1:1including21benign tumors and9malignant tumors. In the series of elder patients, the ratio between males and females was1.83:1including36benign tumors and46malignant tumors.(2) Disease component ratio decreased in order of epithelial tissue (362cases,60.64%,362/597), softtissue(122cases,20.44%,122/597), lymphohematopoietic tissue (45cases,6.46%,45/597), bone and cartilaginous tissue (44cases,7.37%,44/597), ectopic intracranial tumors (8cases,1.34%,8/597) Disease component ratio of chidren decreased in order of softtissue tumors, lymphohematopoietic tissue tumors, bone and cartilaginous tissue tumors, ectopic intracranial tumors and epithelial tissue tumors.And disease component ratio of elder decreased in order of epithelial tissue tumors, softtissue tumors, bone and cartilaginous tissue tumors and lymphohematopoietic tissue tumors. The malignant tumors ranked in the top five were squamous carcinoma, lymphoma,adenoid cystic carcinoma, malignant melanoma and esthesioneuroblastoma, while,the five most frequent benign tumors were papilloma, fibroma, osteoma, angioma and ectopic intracranial tumors,respectively. In addition,19cases of other types of tumors were collected.(3) Surgery is the main strategy for benign tumors.And comprehensive treatment, which were combinded with other modalities, is the main strategy for maligant tumors.In these193NIP patients,37cases were followed up missing. In this series of156patients, there were98males and58females, aged from19to77years, with a median of53years. By Krouse classification,there were26cases in stage Ⅰ;33cases in stage Ⅱ;94cases in stageⅢ and3cases in stage IV. Among these patients,99cases were treated endoscopically;26cases were treated by traditional surgical techniques, and31cases by endoscopic surgery combined with an external approach. With a follow-up of3～11years, the recurrence rate for these three surgery group were9.09%23.08%and12.90%. There were not significant differences among these three groups (P>0.05). As for the recurrence rate for these four stages were3.85%、12.12%14.89%and0.00%.There were not significant differences among four stages.Conclusions(1) Tumors from different parts of nasal cavity and sinuses,whose pathological types may be highly miscellaneous. The most frequent tumors were Papilloma, osteoma, fibroma, squamous carcinoma, lymphoma,adenoid cystic carcinoma,All have specific clinical characteristics.(2) Tumors in pediatrics and elder have specific clinical and pathological features.The most common neoplasms of chidren are the softtissue tumors,while in the elder is epithelial tissue tumors.(3) Recurrence of inverted papilloma depends on the thoroughness of the first operation. And this recurrence is not unrelated with Surgical methods and Krouse stage.