Rhinosinusal Polyposis and Inverted Papilloma: A Morphometric Comparative Study

Abstract

Introduction Nasal obstruction is one of the main rhinologic complaints, and two diseases must be investigated as differential diagnosis: rhinosinusal polyposis and inverted papilloma. Using traditional methods, the differential diagnosis between these diseases may be difficult. The morphometric study may be a useful tool for differential diagnosis and to define prognosis. Objective Calculate the morphometric values of rhinosinusal polyposis and inverted papilloma and compare the average of variables obtained between the groups. Methods The nasal mucus of 10 patients who had surgery in the Department of Otorhinolaryngology and Surgery of Head and Neck was studied; 5 had rhinosinusal polyposis and 5 had inverted papilloma. After the capture and print of corresponding data of each slide, the largest and smallest diameters of the nuclei were measured and the morphometric variables were calculated: average diameter, perimeter, ratio between largest and smallest diameter, volume, area, ratio of volume to area, form coefficient, contour index, and eccentricity. Results We found a significant difference (p < 0.05) between the two groups in the following morphometric variables: largest diameter, smallest diameter, average diameter, volume, area, perimeter, and ratio of volume to area, indicating that these parameters can be useful in diagnostic differentiation between these diseases. Conclusion We founded morphometric variables higher in patients with inverted papilloma, which can be related to the neoplastic origin of the inverted papilloma. The analysis of nuclear parameters is an instrument of great value in the differential diagnosis between rhinosinusal polyposis and inverted papilloma.

Inverted Papilloma of the Septum

“…Sinonazalni invertni papilomi najčešće nastaju u području lateralne stijenke nosne šupljine te u maksilarnom sinusu 3 . Uglavnom su slični nosnim polipima, međutim za razliku od njih ovi se tumori uglavnom pojavljuju unilateralno 5 . Tumori koji nastaju u području nosnih školjki i nosnog septuma smatraju se invertnim papilomima s medijalnim ishodištem te se pojavljuju znatno rjeđe 4,6 .…”

Nasal polyposis: A semiquantitative morphometric histopathological study

“…Nasal inflammatory polyps are nonneoplastic proliferations of the sinonasal mucosa composed of both epithelial and stromal elements. The pathogenesis of these lesions is still uncertain; however, mucosal edema and inflammation, cytokine secretion, and collagen synthesis stimulated by eosinophils have all been implicated 1,2,3 ; polyps are frequently associated with salicylates intolerance, asthma and cystic fibrosis 1,2,3,4,5,6,7,8,9 . Symptoms at presentation include nasal obstruction, rhinorrhea, headache, impaired sense of smell and postnasal discharge 1,2,3,4,5,6 .…”

Surgical Treatment of Rhinogenic Contact Point Headache: An Experience from a Tertiary Care Hospital

“…On the other hand, despite intensive contacts of mucosal surfaces, the presence of facial pain is rare in chronic polypous rhinosinusitis due to the lack of innervation of nasal polyp mucous membrane. 7 8 …”