Page 65 - Revista Portuguesa - SPORL - Vol 62. Nº1

Patients were informed, orally and in writing, Results
about the research objectives and this
provision was formalized in the respective
informed consent forms. The inclusion
criteria considered in this investigation were:
patients with a confirmed diagnosis of SPs
studied endoscopically, through imaging with
computed tomography (CT) of the paranasal
sinuses and magnetic resonance imaging
(MRI) and histologically. Patients underwent
surgery and had a minimum follow-up
of 5 years after surgery. Exclusion criteria
included those patients with suspected or
confirmed diagnoses of SPs who voluntarily
discontinued their follow-up and patients
who did not approve the informed consent.
Once the selection of the patient population
and the type of research applied were defined,
the incidence of SPs was evaluated according
to sex and age, clinical manifestations, time
evolution, and endoscopic and imaging
findings. This research was carried out in a
private third-level referral Otorhinolaryngology
Center in Caracas, Venezuela, and approved
by the Ethics Committee of the Institutional
Review Board. This study adhered to the
bioethical principles established in the World
Medical Association's Declaration of Helsinki
and had no external source of funding or
conflict of interest.
Statistical analysis
The statistical analysis of variables studied was
summarized, calculated and evaluated with
Microsoft Excel 2010 and IBM® SPSS®, which
allowed the collection of absolute, relative
and percentage frequencies and measures of
central tendency to determine the diagnostic
efficiency of the studies performed in patients
with SPs through measures of sensitivity,
specificity, predictive values, and the rate
of false positives and negatives recorded.
In addition, the relative levels of statistical
contingency (Fisher's test), diagnostic
coincidence proportions (Cohen's kappa
coefficients) and the levels of diagnostic
accuracy and the reliability of SPs according to
IS levels (Cohen's d test) were also determined. through a bimodal diagnostic approach of
On a database of 27,416 medical records
reviewed, 1,897 cases of patients with the
finding of nasal polyposis were selected, of
which 103 patients were identified with the
histopathological diagnosis of SPs. Patients
with these neoplasms represented 0.4% of
the total number of clinical histories analyzed.
The male/female ratio was 77%/23%, The ages
of the affected patients ranged from 9 to 80
years, with the most affected group being
patients between 51 and 60 years. The clinical
manifestations and nasal endoscopy, imaging
and histopathology findings observed in all
patients were analyzed correlatively. The most
referred symptom was nasal obstruction in 91%
of the patients. In 78%, this nasal obstruction
was reported as unilateral, and in 22% of cases,
nasal obstruction was bilateral. Rhinorrhea
was present in 63% of cases, headache in 34%,
hearing loss and epiphora in 33% and 21%,
respectively. Furthermore, other symptoms
such as epistaxis in 10% of the cases studied,
anosmia in 9% of the patients and alteration
of the external aspect of the face, with
deformation of the nasofacial region in 3%.
Nine percent (9%) of the patients studied did
not present any symptoms and the findings
of lesions were incidental. Endoscopic
examination of the nasal cavities revealed
in all patients the presence of a lobulated
polypoid lesion of different sizes. Ninety-
nine (99%) percent of these patients had
unilateral lesions, and in one patient, lesions
were observed on both sides. In 63% retained
secretions were observed and in 13% evidence
of blood in the affected nasal cavity was also
observed. The presence of a polypoid type
lesion, however small, may be a signal that
should arouse an IS of neoplasia within the
nasal cavity, despite the fact that, in most cases,
this finding could be related to inflammatory
processes. Based on this suspicion criteria,
other complementary studies, which may
be important to clarify the diagnosis of an
early neoplasm, may be indicated. (Figure 1)
All patients were evaluated radiologically
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