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印度中部一家三级医疗中心鼻及鼻窦病变的表现

Presentation of Lesions of Nose and Paranasal Sinuses at a Tertiary Care Center in Central India.

作者信息

Singh Siddharth Gautam, Qureshi Sadat, Jain Leena, Jadia Shalini, Sharma Sandeep

机构信息

Department of E.N.T, Peoples Medical College and Research Center, Bhopal, India.

Department of E.N.T, SMBT Institute of Medical Sciences, Nashik, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2018 Jun;70(2):284-289. doi: 10.1007/s12070-018-1246-2. Epub 2018 Jan 11.

Abstract

A variety of non-neoplastic and neoplastic conditions involve the nasal cavity, paranasal sinus and are fairly common presentation encountered in clinical practice. Sinonasal lesions are a common finding in all age groups. The lesion of nose and paranasal sinuses are very deceptive so, the presenting features, clinical examination, nasal endoscopy, radiodiagnosis and histopathology are employed conjointly to reach a diagnosis. This cross sectional study was conducted between November 2014 and September 2016. 150 patients with nasal or paranasal sinus lesions attending ENT OPD were included. Among 150 patients there was a male predominance in all lesion except malignant lesions and most of the patients 72 (48%) were in the age group 11- 30 years. Mean age of presentation for benign lesions was 33.64 years and of malignant lesions was 49.14 years. The study showed that 96 (64%) of the nose and PNS lesions were of inflammatory nature followed by 22 (15%) benign, 18 (12%) granulomatous and 14 (9%) malignant, Inflammatory polyp being the most common diagnosis. Haemangioma was the most common benign neoplastic lesion whereas in granulomatous lesions most common diagnosis was tuberculosis. The maximum lesions 74 (49%) were in maxillary antrum. The most common clinical presentation was nasal obstruction, with unilateral nasal obstruction seen in 84 (56%) cases and bilateral nasal obstruction in 50 (33.3%) cases. Angiofibroma 6 (4%) was exclusively seen in adolescent males. Olfactory neuroblastoma 4 (2.6%) was diagnosed in females with mean age of presentation of 30 years. Sinonasal lesions display a complex and interesting spectrum of clinical, radiological and histopathologic features. The non-neoplastic lesions are numerous, the morphologic variants of neoplasms are many and most of them present as polypoid masses which are impossible to distinguish clinically. Hence a proper workup including histopathological and radiological categorization is essential in the management of these lesions.

摘要

多种非肿瘤性和肿瘤性疾病累及鼻腔、鼻窦,是临床实践中相当常见的表现。鼻窦病变在所有年龄组中都很常见。鼻和鼻窦病变极具迷惑性,因此,结合临床表现、临床检查、鼻内镜检查、放射诊断和组织病理学检查来做出诊断。这项横断面研究于2014年11月至2016年9月进行。纳入了150例到耳鼻喉科门诊就诊的鼻或鼻窦病变患者。在150例患者中,除恶性病变外,所有病变均以男性居多,大多数患者72例(48%)年龄在11至30岁之间。良性病变的平均发病年龄为33.64岁,恶性病变为49.14岁。研究表明,96例(64%)鼻和鼻窦病变为炎症性,其次为22例(15%)良性、18例(12%)肉芽肿性和14例(9%)恶性,炎性息肉是最常见的诊断。血管瘤是最常见的良性肿瘤性病变,而在肉芽肿性病变中最常见的诊断是结核。最大病变部位为上颌窦74例(49%)。最常见的临床表现是鼻塞,单侧鼻塞84例(56%),双侧鼻塞50例(33.3%)。血管纤维瘤6例(4%)仅见于青少年男性。嗅神经母细胞瘤4例(2.6%)在女性中诊断,平均发病年龄为30岁。鼻窦病变表现出复杂而有趣的临床、放射学和组织病理学特征谱。非肿瘤性病变众多,肿瘤的形态学变异多样,其中大多数表现为息肉样肿块,临床上无法区分。因此,在这些病变的管理中,包括组织病理学和放射学分类在内的适当检查至关重要。

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