Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Otolaryngol Head Neck Surg. 2013 Mar;148(3):509-12. doi: 10.1177/0194599812472656. Epub 2013 Jan 11.
To determine the frequency and clinical relevance of unanticipated histopathologic results in routine sinonasal surgery and evaluate the necessity for histologic processing of nasal septal cartilage, bone, and inferior turbinate specimens.
Case series with chart review.
Tertiary care academic medical center.
A retrospective review of surgical pathology reports on adult patients undergoing sinonasal surgery during a 5-year period from 2005 to 2010 was performed. All cases with the preoperative diagnosis of sinonasal neoplasia, autoimmune disease, or directed septal biopsies were excluded from review.
A total of 1194 pathology reports were reviewed from 1172 individual patients. This included histopathologic evaluation of 1194 septal cartilage and bone specimens and 714 inferior turbinate specimens. None of the patients had unanticipated histopathologic findings that were clinically significant.
Many surgeons obtain histopathologic diagnoses on all tissue removed from a patient. Based on our institutional case series, histopathology of the septum and inferior turbinates in routine sinonasal cases may not be necessary. A value-based approach to processing grossly unremarkable septal and turbinate tissue by waiving histologic processing and subsequent microscopic evaluation could provide significant cost savings.
确定常规鼻窦手术中意外组织病理学结果的频率和临床相关性，并评估对鼻中隔软骨、骨和下鼻甲标本进行组织学处理的必要性。
病例系列和图表回顾。
三级保健学术医疗中心。
对 2005 年至 2010 年 5 年间接受鼻窦手术的成年患者的手术病理报告进行了回顾性分析。所有术前诊断为鼻窦肿瘤、自身免疫性疾病或有针对性鼻中隔活检的病例均被排除在回顾之外。
共对 1172 名患者的 1194 份病理报告进行了回顾，其中包括 1194 份鼻中隔软骨和骨标本以及 714 份下鼻甲标本的组织病理学评估。所有患者均无临床意义的意外组织病理学发现。
许多外科医生对从患者身上切除的所有组织进行组织病理学诊断。基于我们的机构病例系列，常规鼻窦手术中鼻中隔和下鼻甲的组织病理学可能不是必需的。通过放弃组织学处理和随后的显微镜评估，对大体无明显异常的鼻中隔和鼻甲组织进行基于价值的处理，可以节省大量成本。
