Tumores nasossinusais benignos: Do diagnóstico à terapêutica

Autores

  • Patrícia S. Gomes Hospital Senhora da Oliveira - Guimarães

DOI:

https://doi.org/10.34631/sporl.755

Palavras-chave:

Tumores nasossinusais benignos, cirurgia endoscópica nasossinusal, histologia, TC

Resumo

Objectivo: Caracterização clínica, imagiológica e terapêutica dos Tumores Nasossinusais Benignos (TNB).
Desenho do Estudo: Estudo retrospetivo

Material e Métodos: Revisão do processo clínico dos doentes com TNB submetidos a cirurgia endoscópica nasossinusal (CENS) entre 2011 e 2017.
Resultados: 32 doentes com idade média de 55.0±17.5 anos foram incluídos. Os TNB mais frequentes foram os papilomas nasossinusais(43.8%), seguidos dos osteomas (31.3%).Sintomas de apresentação incluíram obstrução nasal (87.5%), cefaleias (37.3%), hipósmia (34.4%) e epistáxis (25.0%). Verificou-se excelente concordância entre a histologia da biópsia e a do espécime cirúrgico (K=0.90). Os PNS apresentaram remodelling ósseo e score Lund-Mackay médio superiores a outros TNB (p<0.01). A CENS foi associada a abordagem externa em 5 doentes, verificando-se recidiva de quatro PNS e um hamartoma.
Conclusões: Os TNB são incomuns e condicionam morbilidade significativa se não diagnosticados atempadamente. Apesar da crescente importância da CENS, o uso associado ou isolado de vias externas é essencial, em casos selecionados, para completa exérese tumoral.

Referências

Harvey RJ, Sheahan PO, Schlosser RJ. Surgical management of benign sinonasal masses. Otolaryngol Clin North Am. 2009 Apr;42(2): 353-75.

El-Naggar AK, Chan JKC, Grandis JR, Takata T et al .The fourth edition of the head and neck World Health Organization blue book: editors' perspectives. Hum Pathol. 2017 Aug;66:10-12

Harvey RJ, Dalgorf DM. Chapter 10: Sinonasal malignancies. Am J Rhinol Allergy. 2013 May-Jun; 27 Suppl 1:35-8.

Piero Nicolai, Paolo Castelnuovo. Benign tumors of the sinonasal tract. In: Flint PW, Haughey BH, Lund V, Niparko JK et al (Eds.), Cummings Otolaringology Head and Neck Surgery -6th edition, Philadelphia, Elsevier; 2015:pp740-51.

Lund VJ, Mackay IS. Staging in rhinosinusitus. Rhinology. 1993 Dec;31:183-4.

Krouse JH. Development of a staging system for inverted papilloma. Laryngoscope. 2000 Jun;110(6):965-8.

Sousa AC, Henriques V, Estevâo R; Rodrigues J et al. Tumores benignos nasossinusais: Estudo retrospetivo. R Port Otolarinolaringol Pat. 2016;54:55-62.

Segal N, Gluck O, Bavnik Y, Plakht Y et al. The usefulness of preoperative biopsy in unilateral nasal masses. Allergy Rhinol. 2014 Mar;5(2):53-5.

Lee JY. Unilateral paranasal sinus diseases: analysis of the clinical characteristics, diagnosis, pathology, and computed tomography findings. Acta Otolaryngol. 2008 Jun;128(6):621-6.

Nair S, James E, Awasthi S, Nambiar S et al. A review of the clinicopathological and radiological features of unilateral nasal mass. Indian J Otolaryngol Head Neck Surg. 2013 Aug;65(2):199-204.

Mortuaire G, Arzul E, Darras JA, Chavalier D. Surgical management of sinonasal inverted papillomas through endoscopic approach. Eur Arch Otorhinolaryngol. 2007 Dec; 264(12):1419-24.

Lund VJ, Stammberger H, Nicolai P, Castelnuovo P et al. European position paper on endoscopic management of tumours of the nose, paranasal sinuses and skull base. Rhinol Suppl. 2010 Jun; 1-143.

Savic DL, Djeric DR. Indications for the surgical treatment of osteomas of the frontal and ethmoid sinuses. Clin Otolaryngol Allied Sci.1990; 15(5):397-404.

Mansour AM, Salti HS, Uwaydat S, Dakroub R et al. Ethmoid Sinus Osteoma Presenting as Epiphora and Orbital Cellulitis: Case Report and Literature Review. Surv Ophthalmol. 1999;43(5):413-26.

El-Mofty S. Psammomatoid and trabecular juvenile ossifying fibroma of the craniofacial skeleton: two distinct clinicopathologic entities. Oral Surg Oral Med Oral Pathol Oral Radiol. 2002 Mar; 93(3):296-304.

Karkuzhali P, Gnanaguruparan A, Bhattachryya M. Psammomatoid ossifying fibroma of sinonasal tract. Otolaryngol Head Neck Surg. 2006 Apr; 134(4):705-7.

London SD, Schlosser RJ, Gross CW. Endoscopic management of benign sinonasal tumors: a decade of experience. Am J Rhinol. 2002 Jul; 16(4):221-7.

Castelnuovo P, Pagella F, Semino L, De Bernardi F et al. Endoscopic treatment of isolated sphenoid sinus lesions. Eur Arch Otorhinolaryngol. 2005; 262(2):142-7.

Post G, Kountakis SE. Endoscopic resection of large sinonasal ossifying fibroma. Am J Otolaryngol. 2005 Jan-Feb; 26(1):54–6.

Maroldi R, Berlucchi M, Farina D, Tomenzoli D et al. Benign neoplasms and tumor-like lesions. In Maroldi R, Nicolai P (Eds.). Imaging in Treatment Planning for Sinonasal Diseases, Berlin, Springer; 2005:pp107-58.

Mathew GA, Ashish G, Tyagi AK, Chandrashekharan R et al. Solitary Fibrous Tumor of Nasal Cavity: A Case Report. Iran J Otorhinolaryngol. 2015 Jul;27(81):307-12.

England DM, Hochholzer L, McCarthy MJ. Localized benign and malignant fibrous tumors of the pleura. A clinicopathologic review of 223 cases. Am J Surg Pathol. 1989;13(8):640-58.

Kessler A, Lapinsky J, Berenholz L, Sarfaty S et al. Solitary fibrous tumor of the nasal cavity. Otolaryngol Head Neck Surg. 1999 Dec;121(6):826-8.

Patel SG, Singh B, Polluri A, Bridger PG et al. Craniofacial surgery for malignant skull base tumors: report of an international collaborative study. Cancer. 2003 Sep; 98(6): 1179-87.

Har-El G. Anterior craniofacial resection without facial skin incisions-a review. Otolaryngol Head Neck Surg. 2004 Jun; 130(6):780-7.

Downloads

Publicado

26-08-2019

Como Citar

Gomes, P. S. (2019). Tumores nasossinusais benignos: Do diagnóstico à terapêutica. Revista Portuguesa De Otorrinolaringologia-Cirurgia De Cabeça E Pescoço, 56(4), 149–154. https://doi.org/10.34631/sporl.755

Edição

Secção

Artigo Original