Histopathological Study of Lesions of Sino-Nasal Tract and Nasopharynx

Background: Nose is the most prominent part of the face with substantial aesthetic and functional significance. It is one of the few organs of body invested with an aura of emotional and cultural importance. Paranasal sinuses are the air-containing cavities in the skull. Nasopharynx is the uppermost part of the pharynx which lies behind the nasal cavities and acts as a conduit for air and is important during swallowing, vomiting, gagging and speech. A variety of non-neoplastic and neoplastic conditions involving the nasal cavity, paranasal sinuses and nasopharynx, are common in clinical practice and their incidence increased with COVID-19 pandemic. Head and neck neoplasia (HNN) is a major form of neoplasia in India, accounting for 23% of all cancers in males and 6% in females. Tobacco and alcohol play an important role in the pathogenesis of HNN. The five-year survival varies from 20?90% depending upon the sub-site of origin and the clinical extent of disease. India has the dubious distinction of having the world's highest reported incidence of HNN in women. (1) Trends and tradition of a clinical entity change from time to time. Till date an analysis of the sino-nasal masses in India population has been lacking. In order to understand this entity better the present study, histopathological study of lesions of sino-nasal tract and nasopharynx was undertaken. Aim: To study the incidence and the histopathological spectrum of various non-neoplastic and neoplastic lesions encountered in the sino-nasal tract and nasopharynx. Materials and Methods: Type of Study: In this Retrospective study a total of 88 Specimens of sino-nasal tract and nasopharynx sent for histopathological examination to Department of Pathology Santhiram medical college and general hospital were considered in the two year study period (December 2018 ? November 2020). All infectious, inflammatory, allergic and neoplastic lesions of sino-nasal tract and nasopharynx were included in the study. The lesions from areas other than sino-nasal tract and nasopharynx and other inadequate biopsy specimens were excluded. Results: The mean age of non-neoplastic lesions was 29.43 years. Most of the lesions showed a male preponderance with overall male: female ratio of 1.7:1. Sino-nasal polyps were the most common non-neoplastic lesions. Mean age of benign was 29.68 years with a male: female ratio of 2:8:1. Hemangioma was the most common benign. All the malignant neoplasms were reported in 5th, 6th, and 7th decades. Mean age s was 62.08 years and lesions were predominant in male sex with overall male: female ratio of 5. Squamous cell carcinoma was the most common malignant lesion followed by nasopharyngeal carcinoma, basal cell carcinoma, adenocarcinoma and undifferentiated carcinoma respectively. Conclusion: Definitive diagnosis requires histopathological examination, as most lesions are either inaccessible for fine needle aspiration cytology. The histologic type and grade of the tumor is representative of the biological behaviour, chemosenstivity and radiosensitivity of the mass and hence has an impeccable impact on its management. Therefore it is important that all lesions should be submitted for histopathological examination. The present study helps to know the prevalence and the distribution of the polypoidal lesions in the nasal cavity and it emphasises that subjecting nasal polyps to histopathological examination remains the mainstay of final definitive diagnosis.