The importance of etiology and imaging in the diagnosis of tumors causing unilateral nasal obstruction

Abstract Objective This retrospective study aims to compare various types of primary sinonasal tumors to each other in distribution, demographics and radiological characteristics in order to determine the prevalence of high-risk patients in differential diagnosis. Methods This single-center chart review study included patients with available CT-scans consistent with unilateral intranasal mass lesions, and postoperative histopathological reports. A SPSS v.25 statistical software package was used to perform logistic regression analysis of the data. The model included age and Lund Mackay (LM) scores as continuous variables and the Hosmer Lemeshow test was used to assess the consistency of the model. A p value of < 0.05 was considered as statistically significant. A total of 1510 publications were identified in a PubMed search. Results Patients aged from 1 to 88 years were classified into inflammatory ( n = 61, 72.6%) and neoplastic ( n = 23, 27.4%) groups. The mean age was significantly higher, a history of smoking was more common ( n = 12, 52.2%) in the neoplastic group vs. inflammatory group. The rates of male patients were 82.6% and 59.0% in the neoplastic group and inflammatory group, respectively and intergroup difference was statistically significant. More patients had comorbidities in the neoplastic groups ( n = 15, 65.2%). Symptom information was available in 74 patients and the most common symptom was nasal obstruction with 62.2% ( n = 46). Although the rate of nasal obstruction was as high as 69.6% in the neoplastic group, intergroup differences did not reach statistical significance ( p ≥ 0.05). The logistic regression analysis revealed that a neoplasm was 10.31 times more likely to cause bone changes on CT scans. Bone changes were present on CT scans in 47.5% of patients in the inflammatory group whereas this rate was as high as 95.7% in the neoplastic group and intergroup difference was statistically significant. The median LM score was statistically significantly higher in the neoplastic group. Conclusion Advanced age, the presence of bone changes on CT scans and higher LM scores might be suggestive of a neoplasia in patients with unilateral sinonasal masses.