Department of Otolaryngology-Head and Neck and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, 26738Tel Aviv University, Tel Aviv, Israel.
Soroka Clinical Research Center, Soroka University Medical Center, Beer-Sheva, Israel.
Ear Nose Throat J. 2021 Sep;100(5_suppl):670S-674S. doi: 10.1177/0145561319872728. Epub 2019 Sep 30.
The necessity to routinely carry out histopathologic examinations of surgically removed polyps in patients with chronic rhinosinusitis with bilateral nasal polyps (CRSwNP) is uncertain. The aim of this study was to describe the histopathology of polyps from a large series of patients who underwent endoscopic sinus surgery for CRSwNP and the rate of neoplasms. This is a retrospective study of the histopathological result of all patients with CRSwNP who underwent functional endoscopic nasal surgery and in whom histologic examination was performed, from 2006 to 2015, in a tertiary medical center. Data on demographics and whether a nasal lesion was suspected for neoplasm prior to surgery were analyzed. Two hundred thirty-five patients underwent bilateral nasal polypectomy and histopathologic examinations of the surgical specimens. The rate of neoplasms in nonsuspicious cases was 2.3% (5 cases) and all were inverted papilloma. To conclude, inverted papilloma and other neoplasms are considered rare incidental findings in patients presenting with bilateral nasal polyps. This study demonstrated a higher rate of the latter than that reported in the literature. Our study further emphasizes that despite the low incidence of these pathologies, a histopathologic examination of every nasal polypectomy is warranted so as not to miss potential serious pathologies. We stress that a routine histopathological examination should be practiced at least in the elderly population.
在患有双侧鼻息肉的慢性鼻-鼻窦炎（CRSwNP）患者中，常规进行手术切除息肉的组织病理学检查的必要性尚不确定。本研究的目的是描述接受内镜鼻窦手术治疗的 CRSwNP 患者中大量息肉的组织病理学特征，以及肿瘤的发生率。这是一项回顾性研究，纳入了 2006 年至 2015 年在一家三级医疗中心接受功能性内镜鼻窦手术且进行了组织学检查的所有 CRSwNP 患者的组织病理学结果。分析了患者的人口统计学数据和术前是否怀疑鼻部病变为肿瘤。235 例患者接受了双侧鼻息肉切除术和手术标本的组织病理学检查。在无可疑肿瘤的病例中，肿瘤的发生率为 2.3%（5 例），均为内翻性乳头状瘤。总之，在双侧鼻息肉患者中，内翻性乳头状瘤和其他肿瘤被认为是罕见的偶发发现。本研究显示后者的发生率高于文献报道。我们的研究进一步强调，尽管这些病变的发生率较低，但仍需要对每例鼻息肉切除术进行组织病理学检查，以免漏诊潜在的严重病变。我们强调，至少应在老年人群中常规进行组织病理学检查。
