Sinonasal organising haematoma – a little known entity

Varghese, Lalee; Mukhopadhyay, Sabyasachi; Mehan, Raghav; Kurien, Regi; Thomas, Meera; Rupa, Vedantam

doi:10.1016/j.bjorl.2018.05.013

Cited by 9 publications

(6 citation statements)

References 14 publications

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“…We have included a group of lesions, framed as "other lesions": 1) opacification, fibrosis and mucosal thickening, which is the most frequent radiological finding of the maxillary sinus [41], but which in our case was diagnosed as a polyp in the CRS; 2) a hyperostosis, which was confused with a benign tumour and which tend to be normal anatomical variations [43]; 3) an organized hematoma that was suspected to be malignant in a patient with chronic myeloid leukemia and that has been recently described [44]; 4) non-necrotizing granulomatous disease in a 33-year-old woman as part of a clinical picture of eosinophilic granulomatosis with polyangitis, an autoimmune systemic disease manifesting as asthma, recurrent sinusitis and peripheral eosinophilia [45].…”

Section: Discussionmentioning

confidence: 86%

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

et al. 2020

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Background Diagnosis of maxillary sinus pathology must include the clinical radiological study (CRS) and histopathological analysis. The aim of this study is 1) to describe the clinicopathological features of maxillary sinus lesions, obtained successively in a single medical centre over the last 10 years and 2) to determine the sensitivity and specificity for the diagnosis of malignant lesions based exclusively on the CRS. Methods It is a single-centre observational retrospective clinical study on patients who attended the University Hospital Complex of Santiago de Compostela (CHUS) with sinus pathologies during the period of 2009–2019. Results The sample consisted of 133 men (62.1%) and 81 women (37.9%), with an average age of 46.9 years (SD = 18.8). In terms of frequency, the most frequent pathology was the unspecified sinusitis (44.4%), followed by polyps (18.2%), malignant tumours (9.8%), inverting papilloma (7.5%), fungal sinusitis (4.7%), cysts (3.7%), benign tumours (2.3%), mucocele (2.3%) and other lesions (1.9%). Cysts and benign tumours were diagnosed earliest Vs malignant tumours (65.2 years (SD = 16.1)) were diagnosed the latest (p < 0.001). Based only on the CRS for malignancies, diagnostic indexes were 71.4% sensitivity and 97.9% specificity, with a Kappa value of 0.68 with (p < 0.001). Conclusion Maxillary sinus pathology is very varied with therapeutic and prognostic repercussions. CRS is sometimes insufficient and histopathological confirmation is essential.

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Section: Discussionmentioning

confidence: 86%

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

et al. 2020

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“…However, we cannot definitively conclude that this is the only reason why this disease is more prevalent in East-Asian regions with an increasing prevalence, and we cautiously suggest that genetic vulnerabilities or environmental factors may also play a role, which is also mentioned by Wu et al 8 that racial disparity may contribute in the epidemiology of sinonasal OH. Most studies on this disease have been published in East Asian countries (Korea, 1,3,6,[10][11][12][13][14]20,24 China, 7 and Japan 2,15,16,18,22 ), whereas only 7 reports from the United States, 8 10 from Brazil, 19 2 from India, 25 and 2 from Tunisia 17 have been documented. Because all our present study patients were of Korean descent, we were unable to further clarify this suggestion of Wu and colleagues.…”

Section: Discussionmentioning

confidence: 99%

“…5,7 Although some scholars have claimed that preoperative embolization may reduce intraoperative blood loss and the elapsed surgical times, 15,16 many other surgeons have demonstrated that endoscopic methods alone may be sufficient to safely remove sinonasal OH in most patients. [6][7][8]13,[17][18][19] In 2016, Pang et al published their clinical, radiological, and treatment findings for 84 sinonasal OH patients that had been treated over a 10-year period in China, which was the largest sample size for this disease to have been documented to date in a single report. 7 However, Pang et al s' study lacked information on preoperative punch biopsies, laboratory results, maxillofacial injuries, dental implants, and the diagnostic sensitivity of various OH diagnostic modalities.…”

Section: Introductionmentioning

confidence: 99%

Sinonasal Organizing Hematoma: Demographics, Diagnosis, and Treatment Outcomes of 112 patients

Park,

Choi,

Kim

et al. 2023

The Laryngoscope

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IntroductionSinonasal organizing hematoma (OH) is a rare, nonneoplastic lesion that often presents with epistaxis, a reddish mass, and destruction of the involved sinonasal structures. Due to its rarity, the demographics, diagnostic modalities, treatment strategies, and outcomes have not yet been studied in a large, long‐term study.Materials and MethodsRetrospect cohort of 112 sinonasal OH patients treated between 1997 and 2020 in a tertiary, university hospital were evaluated. Demographics, systemic comorbidities, sinonasal surgery history, serum laboratory tests, radiological findings, and treatment results were collected. The present study aimed to assess the accuracy of preoperative computed tomography (CT), Gadolinum‐enhanced magnetic resonance (MR), and punch biopsies in detecting sinonasal OH as the most likely diagnosis. In addition, incidental differences by age and year of diagnosis were calculated using the Poisson log‐linear regression model.ResultsThe median age was 44, and 58% were male. Fewer than 20% of these cases had a chronic systemic comorbidity, bleeding tendency, or sinonasal surgery history. MR had the highest accuracy of (87%) to detect sinonasal OH as the most likely diagnosis, compared with contrast‐enhanced‐CT (53%), punch biopsy (49%), and non‐enhanced‐CT (16%) (all <0.05). Sinonasal OH incidence did not vary by age, but the yearly rate significantly increased by 1.05 times over 23 years (p < 0.05). Notably, 84% of 112 patients received surgical removal through the assistance of an endoscope, and none had substantial bleeding without preoperative embolization.ConclusionSinonasal OH was observed regardless of age, sex, systemic comorbidities, bleeding tendency, prior sinonasal surgery, or trauma. Preoperative MR gives the highest accuracy for detecting this disease. Sinonasal OH may be safely managed with endoscopic‐assisted surgery removal without embolization.Level of Evidence4 Laryngoscope, 2023

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“…SOH has been associated with prior history of head and neck surgery, hypertension, coagulopathies, end stage renal disease and liver cirrhosis. [1][2][3] The history of alcoholic liver cirrhosis along with coagulopathies associated with cirrhosis may have contributed to the development of this lesion in our patient. A history of cigarette smoking and atopy have also been described in approximately 11% and 13% of those presenting with SOHs respectively.…”

Section: Discussionmentioning

confidence: 99%

“…They remain, however, a relatively unknown entity that is often mistaken for malignancy due to their expansive local destruction. 1 – 4 While demographic, clinical, and radiographic findings are useful in the diagnosis of this paranasal sinus mass, immunohistochemical evidence is often necessary to establish a definitive diagnosis. 3 …”

Section: Introductionmentioning

confidence: 99%

Diagnostic dilemma – sinonasal organizing hematoma

James

Shackelford

Gudis

et al. 2020

SAGE Open Medical Case Reports

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Sinonasal organizing hematomas are benign lesions often mistaken for malignancy due to their aggressive appearance on diagnostic imaging and endoscopic findings that favor advanced disease. The destructive nature of this pathology paired with the rarity of the presentation often results in diagnostic deception that may escalate intervention planning and affect discussion of prognosis with patients. Herein, we present a case of a 56-year-old male with left-sided nasal obstruction and daily epistaxis, where computed tomography imaging revealed heterogeneous opacification of the left maxillary sinus, erosion of the left inferior orbital wall and extension into the nasal cavity. Although clinical and radiographic presentations of sinonasal organizing hematomas can be managed definitively with endoscopic intervention, there is a need to increase awareness of this entity among clinicians to improve our prognostic counseling with patients.

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Sinonasal organising haematoma – a little known entity

Abstract: Awareness of this relatively new clinical entity and its evaluation and treatment is important for otolaryngologists, maxillofacial surgeons and pathologists alike. Despite the clinical picture of malignancy, histopathological features of benign disease can safely dispel such a diagnosis.

Cited by 9 publications

References 14 publications

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study

Sinonasal Organizing Hematoma: Demographics, Diagnosis, and Treatment Outcomes of 112 patients

Diagnostic dilemma – sinonasal organizing hematoma

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