Nasal fibroscopy as a routine screening procedure of sinonasal adenocarcinoma of woodworkers: French longitudinal case study.

BACKGROUND

The purpose of this study was to assess the relevancy of flexible nasoendoscopy as a routine screening procedure of sinonasal adenocarcinoma among people occupationally exposed to wood dust.

METHODS

This study included woodworkers, occupationally exposed to wood dust. Evaluations were scheduled at the time of inclusion (T0) and after a 2-year period (T1). A questionnaire was used for standardized data collection. The score was based on anatomic landmarks on each side that are parts of the olfactory clefts: the area of middle turbinate, the anterior part of the olfactory cleft, the top of the choanal arch, the spheno-ethmoidal recess, the posterior part of the olfactory cleft, and the middle part of the olfactory cleft.

RESULTS

A total of 965 nasoendoscopies (T0+T1) were performed. Olfactory clefts were visualized in 72% of the cases. Nasoendoscopies revealed pathological findings in 33.6% of cases: polyps, thick nasal secretion aspect, mucous edema, retractile scars and synechia, crusts, mucous erythema, and growth. One case of carcinoma was confirmed. Adverse effects (epistaxis, blood mark on the endo-sheath, sneezing, or rhinorrhea) after the medical procedure occurred in 30% of cases without severe complications.

CONCLUSION

Flexible nasoendoscopy offers meaningful efficacy and a promising safety profile, and, therefore, could become the new cornerstone of the routine screening procedure of sinonasal adenocarcinoma among woodworkers.