Page 73 - Revista Portuguesa - SPORL - Vol 62. Nº1

be enlightening in the diagnosis of a neoplastic imaging clinical criteria commonly observed
disease and thus contribute to its diligent and
efficient treatment. 7, 8, 15 The IS proposed in this
work contemplates all the endoscopic and
imaging evidence usually observed in SPs as
clinical parameters. The score generated in
its correlation makes it possible to establish
the levels of diagnostic presumption of these
neoplasms. Correlative analysis office-based
nasal endoscopy, CT, MRI and biopsies are
vitally important in the evaluation of this
SPs and they are in conjunction represents
an easy and proper guidance strategy for its
timely diagnosis and subsequent preoperative
planning treatment and follow-up.
Unfortunately review of pertinent literature
regarding correlative analysis office-based
nasal endoscopy, CT, MRI and biopsies no
conclusive data are available on this point. In
this study we investigated a large series of SPs
to identify differences of presentation y clinical
features, behavior and precision diagnosis.
Although the available literature is extensive
in the individual study of the radiological,
histological and phenotypic of SPs, the
available correlational studies have generally
been limited an only been to evaluate sinus CT
scan confronted with MRI findings or common
radiological and histological characteristics in
these neoplasms. 7 – 15, 20, 21
In this study we investigated a large series
of SPs to identify differences of presentation
y clinical features, behavior and precision
diagnosis. With a cohort size of 103 cases
(67% IPs, 30% FPs and 3% OPs), this series is
one representative study that addressing
correlative analysis office-based nasal
endoscopy, CT, MRI of sinonasal papillomas.
SPs is usually diagnosed in the late stages in
average, 1 - 4 years after the first appearance
of sinonasal symptoms, therefore, early
diagnosis is rare. A simple strategy for early
and timely diagnosis office-based that
emerges from our study is establishing
an index of suspicion of neoplasms. The
establishment of an index of suspicion
through a scale proposed in our research
based in the correlation of the endoscopic and
in the patients studied from the initial finding
of an endonasal polypoid mass allowed to
identify early developed lesions observed
in our investigation through this scale was
significant, and it reached 19%, in contrast
to the incidence reported by some authors,
who place it at less than 1%. 22, 23 Likewise the
establishment of this correlational suspicion
scale allowed to identify SPs with moderated
(31%), and advanced growth (50%). Statistical
validation of precision and diagnostic accuracy
observed in the correlation of endoscopic and
imaging studies performed as the parameters
of the formulated IS revealed a high level of
reliability at verifying the suspicion of this type
of neoplasms.
Conclusion
Correlational clinical parameters of the
proposed suspicion index correlational scale
of clinical assessment of SPs and the statistical
validation of accuracy diagnostic levels
revealed a high level of reliability at verifying
the suspicion of this type of neoplasms.
Nevertheless, we understand that is important
to promote future multicenter studies with
large sample studies are needed to verify even
more this diagnostic scale.
The present state of knowledge about this
neoplasia of unpredictable clinical behavior
favors prolonged study.
Conflict of interests:
The authors declare that they have no conflict
of interest regarding this article.
Data confidentiality:
The authors declare that they guaranteed
confidentiality in the publication of data of
patients.
Protection of people and animals:
The authors declare that they followed the
regulations established by the Commission
for Clinical Research and Ethics and the
Declaration of Helsinki of the World Medical
Association.
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