Unilateral Sinonasal Symptoms

Abstract

OBJECTIVE: The aim of the study was to describe the pathology in patients with unilateral sinonasal symptoms and to identify variables that may predict neoplastic pathology. STUDY DESIGN: Retrospective chart review. METHODS: A retrospective analysis was completed on 207 consecutive patients with sinonasal symptoms, most of whom underwent functional endoscopic sinus surgery from 2005 to 2008. Of the charts reviewed, 63 patients had unilateral sinonasal symptoms with unilateral opacification of paranasal sinus computed tomography scans. Presenting symptoms and radiographic, surgical, and pathologic findings were analyzed. RESULTS: All 63 patients underwent surgical management for their symptoms, and specimens were sent for pathologic evaluation. There were 12 cases of antrochoanal polyp, 14 of nasal polyposis, 8 of chronic rhinosinusitis, 7 of concha bullosa, 4 of retention cyst in maxillary sinus, 2 of mucocele, 3 of oroantral originated cyst, and 13 cases of benign or malign neoplastic diseases, some of which were extremely rare cases such as pleomorphic adenoma, ameloblastoma, schwannoma, myxoma, and non-Hodgkin lymphoma. Nasal discharge was more common in inflammatory than neoplastic disease. However, epistaxis was more common in neoplastic disease. CONCLUSIONS: A wide variety of pathologic findings present with unilateral sinonasal symptoms. A careful history, examination, and radiographic studies can often determine the responsible disease process. Histologic confirmation remains obligatory for diagnosis. There are also some rare cases, which should be considered in differential diagnosis of unilateral polyp or mass lesion on nasoendoscopy.