Characterization and Outcome of Patients Presented with Unilateral Nasal Disease to ENT unit at Hillah, Iraq

Abstract

Background: A common finding during daily otolaryngological practice is a patient with unilateral nasal
symptoms, nasal polyp or mass. The causes behind most cases of unilateral nasal disorder are inflammatory
in nature and responds well to medical intervention and rarely there is need for surgical management. The
possibility of neoplastic nature is high when there is unilateral nasal complaint or pathology as neoplastic
conditions during their early stages may mimic inflammatory pathologies.
Aim of the Study: The aim of the current study was to highlight the causes of unilateral nasal disease, their
most frequent mode of presentation, management strategies and outcome in a sample of Iraqi patients.
Patients and Method: The current prospective study included 96 patients, 42 males and 54 females, with
signs and symptoms suggestive of unilateral nasal disease. The study was carried out at Hillah General
Teaching Hospital, Babel province, mid-Euphrates region of Iraq and the work with this study has extended
from January 2014 to August 2019. All enrolled patients were subjected to routine ENT examination and
office flexible endoscopy. Patients were managed by functional endoscopic sinus surgery for purpose of
excisional or incisional biopsy.
Results: The current study included 96 patients with a mean age of 49.09± 7.43 years and an age range of 39 to
67 years. There were 42 males and 54 females. The results of complete evaluation have shown the following
pathologies at the end of the study: nasal polyposis (31, 32.3%), chronic rhinosinusitis without polyp (16,
16.7%), antrochoanal polyp (14, 14.6%), inverted papilloma (11, 11.5%), frontoethmoidal mucocele (7,
7.3%), concha bullosa (4, 4.2%), squamous cell carcinoma (3, 3.1%), rhinolith (2, 2.1%), fibrous dysplasia
(2, 2.1%), adenocarcinoma (2, 2.1%), malignant melanoma (1, 1.0%), cavernous hemangioma (1, 1.0%),
pyocele in concha bullosa (1, 1.0%) and non Hodgkin’s (1, 1.0%). Therefore, in the current study, nasal
polyposis was the commonest cause of unilateral sinonasal disease followed by chronic rhinosinusitis
without polyp, antrochoanal polyp and inverted papilloma. The rate of malignant neoplasms was low.
Conclusion: Differentiating the neoplastic nature form non-neoplastic nature of unilateral nasal pathology
is the most critical management step and in the current study, nasal polyposis was the commonest cause
of unilateral sinonasal disease followed by chronic rhinosinusitis without polyp, antrochoanal polyp and
inverted papilloma. The rate of neoplastic malignant conditions was low.