尼日利亚三级卫生保健中心鼻窦肿块的临床流行病学表现

W. Adegbiji, S. Aremu, Ganiyu O. Akanbi, J. Omotayo
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引用次数: 2

摘要

背景:鼻窦肿块在世界范围内是常见的,其临床特征从单纯的鼻窦息肉到恶性肿瘤都有。本研究旨在确定鼻窦肿块的患病率、社会人口学特征、临床特征、临床表现和治疗结果。材料与方法:回顾性研究我中心耳鼻喉科近十年(2008年11月至2018年10月)的鼻窦肿物患者。数据从诊所登记和医院病历中检索。检索社会人口学特征、临床表现、检查结果、CT扫描结果、诊断和治疗结果等信息。采用SPSS 18.0对所得数据进行整理和分析。结果:研究期间患者总数4678例,男性占62.9%,男女比例为1.7:1。双侧占44.3%,左侧占32.0%,右侧占23.7%。多发葡萄状鼻窦肿块占50.5%,单鼻窦肿块占49.5%。最常见的解剖来源为筛窦(50.5%)。主要临床表现为鼻塞83.5%,鼻溢63.9%。肿块扩展到52.6%的鼻内/鼻窦和34.0%的眼眶。组织学诊断以单纯性鼻筛息肉(49.5%)、鳞状细胞癌(17.5%)、鼻后鼻孔息肉(9.3%)和内翻性乳头状瘤(9.3%)为主。组织学检查显示单纯性炎性鼻息肉占58.8%,良性肿瘤占13.4%,恶性肿瘤占23.7%。手术占76.3%,手术加放疗占16.5%,放化疗占7.2%。肿瘤复发和恶性死亡分别为8.2%和2.1%。结论:鼻窦肿块被认为是一种简单的疾病,伴有鼻塞和鼻分泌物。它由息肉和恶性肿瘤组成。鼻息肉比肿瘤更常见。鼻窦肿块最常见的起源是筛窦,这可能是因为我们的研究显示,息肉是鼻窦肿块最常见的原因。进一步的检查显示大多数单侧鼻窦肿块为肿瘤。他们管理不善,并在晚期向耳鼻喉科医生,头颈外科医生提出。晚期患者接受姑息治疗,导致高复发率和病死率。因此,强烈建议进行健康教育、系列和早期筛查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinicoepidemiological Presentation of Sinonasal Mass in A Nigerian Tertiary Health Care Centre
Background: Sinonasal masses are common worldwide with clinical entity ranges from simple sinonasal polyps to malignancy. This study aimed at determining the prevalence, Sociodemographic features, clinical characteristics, clinical presentation, and management outcome of sinonasal masses. Materials and Methods: This was a retrospective study of patients with sinonasal masses in ear, nose and throat department of our center over a period of ten years (from November 2008 to October 2018). Data were retrieved from the clinic register and hospital medical record. Information on sociodemographic features, the clinical presentation of presentation, examination findings, CT Scan findings, diagnosis and treatment outcomes were retrieved. Data obtained were collated and analysed by using SPSS version 18.0. Results: The total number of patients seen over the studied period was 4,678 Male accounted for 62.9% with male to female ratio of 1.7:1. Sinonasal masses were bilateral in 44.3%, left-sided in 32.0% and right-sided in 23.7. Multiple grapelike sinonasal masses accounted for 50.5% while single sinonasal masses accounted for 49.5%. Commonest anatomical origin was ethmoid sinuses in 50.5%. Main clinical features were nasal blockage 83.5% and nasal discharge 63.9%. Masses extension was into 52.6% Intranasal/sinuses and 34.0% orbital extension. Main histological diagnosis were ethmoidal (simple) nasal polyps in 49.5%, squamous cell carcinoma in 17.5%, antrochoanal polyp in 9 3% and inverted papilloma in 9.3%. Histological examination showed simple inflammatory nasal polyps in 58.8%, benign tumour in 13.4% and malignant tumour in 23.7%. Patients were managed by 76.3% surgery, 16.5% surgery and radiotherapy and 7.2% chemoradiotherapy. Recurrent masses and death from malignancy were 8.2% and 2.1% respectively. Conclusions: Sinonasal masses are perceived and presented as a simple disorder with nasal obstructions and discharge. It consists of polyps and malignant tumour. Nasal Polyps are commoner than the neoplastic tumour. The commonest origin of the sinonasal masses was ethmoid sinuses which may be because polyps are the most common causes of sinonasal masses as shown in our study. Further evaluation revealed that majority of the unilateral sinonasal masses were neoplastic. They are poorly managed and presented in advanced stage to the otorhinolaryngologist, head and neck surgeon. Late presented patients had palliative treatment with resultant high recurrence and fatality. Thus Health education, serial and early screening are highly recommended.
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