Clinico-pathological Profile of Sinonasal Masses as Seen at the Kenyatta National Hospital

Abstract

Background: Sinonasal masses present a spectrum of lesions found in the sinonasal tract ranging from non-neoplastic to neoplastic lesions but may have similar clinical presentation with significantly different histopathological diagnosis, management, and prognostic implications. Understanding the clinicopathological spectrum of these masses helps in optimizing clinical care. Objective: To determine the clinico-pathological profile of sinonasal masses as seen at the Kenyatta National Hospital. Study Design: This was a hospital based descriptive cross-sectional study. Study Setting and population: 67 patients diagnosed with a sinonasal mass at the Otorhinolaryngology, maxillofacial, ophthalmology and oncology departments at the Kenyatta National Hospital. Methodology: 67 patients were recruited into the study via convenience sampling technique and gave informed consent. Clinical history was recorded followed by a physical examination. Paranasal Computed Tomography Scan images were done followed by nasoendoscopy and biopsy of the mass for histology. Results: A total of 67 patients with sinonasal masses were examined. The proportion of female and male participants was 50.7% and 49.3% respectively with a M:F ratio of approximately 1:1. Mean age of presentation 40.86 ± 20.8 years. Nasal obstruction was most common presenting complaint at 92.5% with aural complaints least at 13.4%. mean duration of symptoms was 14.54(±13.5) months. Malignant lesions and non-malignant lesions accounted for 35.8% and 64.2% respectively. Most common malignant lesion was squamous cell carcinoma with peak incidence in the fifth decade. Conclusion: Most common etiology of sinonasal masses was non-neoplastic with inflammatory polyps predominant in the 3rd decade. Malignant sinonasal masses were common in the 5th to 8th decade, 40% of which had cervical lymphadenopathy with squamous cell carcinoma as the most prevalent histological type. Nasal obstruction followed by nasal discharge were the most common presenting symptoms. Extension beyond sinonasal tract especially with orbital involvement and cranial nerve III palsy are highly indicative of a malignant diagnosis.