Importance of routine histology in paranasal sinus surgery

Introduction Paranasal sinus surgeries are among the most common otorhinolaryngological surgical procedures. The majority of these interventions are based on chronic inflammation. Therefore, the economic value of routine histology is more and more object of discussion, especially in cases without clinical suspicion of malignancy. The aim of this work was to determine the importance of routine histologies in sinus surgery.

Methods Data from 3370 patients who underwent sinus surgery were analyzed retrospectively. The localization, patient characteristics, initial diagnosis based on clinical and radiological findings as well as the histological results, especially with reference to the initially expressed suspected diagnosis, were evaluated.

Results In 3370 examined histological samples, 175 (5,19%) showed malignancy, 167 (4,96%) revealed a benign tumor and 143 (4,24%) patients had an autoimmune disease or a responsible underlying systemic disease. A clinical or radiological suspicion of malignancy could predict a therapy-relevant diagnosis in a high number of cases. Out of 2885 preoperatively inconspicious patients, however, almost 2% had an unexpected histology warranting further therapy.

Conclusion Sinus surgery continues to be an important cornerstone of ENT surgery. Even if clinical and radiological findings often make important contributions to the diagnosis, unexpected and therapy-relevant findings are repeatedly found in routine histology. Therefore standardized histological examinations in sinus surgery should be continued.

Publication History

Article published online:
24 May 2022