Sinonasal Lesions Research Articles

Cholesterol granuloma of the maxillary sinus: a case report

BackgroundCholesterol granuloma is not a common entity in the paranasal sinuses. It is a foreign body reaction to the cholesterol crystal deposition. Mostly associated with chronic middle ear diseases.Case presentationThis article reports a case of cholesterol granuloma in the maxillary sinus. A 23-year-old Asian man presented with cough, nasal obstruction, and postnasal discharge. On endoscopy, there was a mass protruding from the right maxillary ostium. On computed tomograpy imaging, there was a polypoidal mass in the right maxillary sinus. Endoscopic sinus surgery was performed, the cholesterol granuloma was removed from the right maxillary sinus, and the tissue was submitted for histopathological examination, which showed foreign body giant cell reaction to cholesterol crystals.ConclusionCholesterol granuloma of maxillary sinus is not common and often missed by clinicians. It is necessary to consider the cholesterol granuloma of maxillary sinus in the differential diagnosis sinonasal lesions. Histopathological analysis is required for confirmation and should be removed surgically. This case may help as a reference for clinician to approach these kinds of cases.

Common Characteristics of Sinonasal Inflammation Associated with IgG4-Related Disease and Other Chronic Inflammatory Diseases: A Retrospective Observational Study

Plain Language SummaryImmunoglobulin G4-related disease (IgG4-RD) is a systemic inflammatory disease characterized by elevated serum IgG4 levels and tissue IgG4-positive cells. A part of IgG4-RD patients has sinonasal lesions. Because other inflammatory diseases also have features common to IgG4-RD, accurate knowledge of IgG4-RD is required. However, very little is known about IgG4-related rhinosinusitis. This study retrospectively analyzed clinicopathological features of IgG4-related rhinosinusitis and compared IgG4-related rhinosinusitis with other inflammatory diseases. Seven patients with sinonasal lesions and high serum IgG4 levels were retrospectively reviewed. Six of 7 patients were diagnosed with IgG4-RD, while one was diagnosed with granulomatosis with polyangiitis (GPA). In the 6 patients with IgG4-RD, intranasal findings showed nasal polyps in 3 patients (50%) and computed tomography showed ethmoid sinus involvement in 5 patients (83%), which shared common features with eosinophilic sinusitis (ECRS). However, no patients showed histopathological eosinophil infiltration. Although the patient with GPA revealed tissue infiltration of IgG4-positive cells in the nasal biopsy, the patient also had saddle nose and positivity of myeloperoxidase-antineutrophil cytoplasmic antibody (ANCA), which indicated GPA. We diagnosed the patient with GPA, which is a known mimicker of IgG4-RD. In this study, the patients with IgG4-related rhinosinusitis had clinical and pathological characteristics similar to those of ECRS and GPA. IgG4-related rhinosinusitis should be diagnosed based on not only tissue infiltration of IgG4-positive cells but also systemic findings including nasal findings and serum ANCA levels. IgG4-RD should be ruled out in patients with eosinophilia without histopathological eosinophil infiltration.

Sinonasal manifestations of granulomatosis with polyangiitis: A retrospective analysis

ObjectiveThis study aimed to examine the characteristics of nasal and imaging findings of sinonasal lesions in granulomatosis with polyangiitis (GPA) patients and how these lesions change over time in both the active and remission phases of the disease. MethodsWe retrospectively reviewed GPA patients with sinonasal lesions who were followed up at our department between January 2005 and December 2020. The following data were collected: age, sex, symptoms at initial presentation, anti-neutrophil cytoplasmic antibody (ANCA) type, and histopathological, nasal (initial and follow-up), and imaging (initial and follow-up) findings. ResultsThis study included 17 patients with GPA aged 30 to 79 years. Computed tomography (CT) of the sinuses showed mucosal thickening in 16 patients, bone thickening in 12, bone destruction in 4, and an orbital invasion mass in 3 at the time of diagnosis. After initiating treatment, mucosal thickening of the sinuses improved in 3 of 16 patients and remained unchanged in 13. Bone thickening at the time of diagnosis remained unchanged in 10 of 12 patients and worsened in 2; 1 patient displayed newly developed bone thickening. Destructive nasal findings on CT were positive for proteinase 3-ANCA. ConclusionsOur study revealed that mucosal thickening, bone thickening, bone destruction, and orbital invasion mass were major CT findings in patients with GPA. Intranasal findings such as granulations, crusting, and necrosis were seen in the active phase; moreover, saddle nose, loss of turbinate, and nasal septal perforation were subsequently seen in the course of the disease. Sinonasal findings of GPA vary depending on the disease stage and period.

Clinicopathological study of masses of nasal cavity and paranasal sinuses and its correlation with radiology

Abstract Background: Nasal and paranasal abnormalities frequently represent the primary observations in the otorhinolaryngology domain. Thorough clinical evaluation and radiological methodologies aid in establishing a preliminary diagnosis; however, histopathological examination (HPE) remains indispensable for confirming a definitive diagnosis. The objective is to determine the demographic breakdown of patients exhibiting sinonasal lesions and to evaluate and correlate clinical and radiological observations with histopathological diagnoses. Materials and Methods: This ambispective observational study involved 128 sinonasal lesions diagnosed via histopathology spanning 3 years (2020–2023). All pertinent clinical radiological observations were recorded, and tissue samples underwent staining with hematoxylin and eosin (H&E), special stains, and immunohistochemistry (IHC) when necessary. The collected data were organized into tables, and statistical analyses were conducted. Results: Among the 128 cases examined, 98 (76.56%) were identified as non-neoplastic lesions, 14 (10.93%) as benign neoplasms, and 16 (12.50%) as malignant lesions through HPE. The male-to-female ratio stood at 1.2:1. The highest number of cases was observed within the age bracket of 21–40 years. Nasal obstruction emerged as the predominant symptom, accounting for 46 (35.93%) cases. Conclusion: A broad range of lesions can impact the sinonasal tract. While clinical and radiological characteristics may exhibit similarities, histopathology is the ultimate standard for confirming a definitive diagnosis.

Synthetic MRI and amide proton transfer-weighted MRI for differentiating between benign and malignant sinonasal lesions.

To explore the value of the synthetic MRI (SyMRI), combined with amide proton transfer-weighted (APTw) MRI for quantitative and morphologic assessment of sinonasal lesions, which could provide relative scale for the quantitative assessment of tissue properties. A total of 80 patients (31 malignant and 49 benign) with sinonasal lesions, who underwent the SyMRI and APTw examination, were retrospectively analyzed. Quantitative parameters (T1, T2, proton density (PD)) and APT % were obtained through outlining the region of interest (ROI) and comparing the two groups utilizing independent Student t test or a Wilcoxon test. Receiver operating characteristic curve (ROC), Delong test, and logistic regression analysis were performed to assess the diagnostic efficiency of one-parameter and multiparametric models. SyMRI-derived mean T1, T2, and PD were significantly higher and APT % was relatively lower in benign compared to malignant sinonasal lesions (p < 0.05). The ROC analysis showed that the AUCs of the SyMRI-derived quantitative (T1, T2, PD) values and APT % ranged from 0.677 to 0.781 for differential diagnosis between benign and malignant sinonasal lesions. The T2 values showed the best diagnostic performance among all single parameters for differentiating these two masses. The AUCs of combined SyMRI-derived multiple parameters with APT % (AUC = 0.866) were the highest than that of any single parameter, which was significantly improved (p < 0.05). The combination of SyMRI and APTw imaging has the potential to reflect intrinsic tissue characteristics useful for differentiating benign from malignant sinonasal lesions. Combining synthetic MRI with amide proton transfer-weighted imaging could function as a quantitative and contrast-free approach, significantly enhancing the differentiation of benign and malignant sinonasal lesions and overcoming the limitations associated with the superficial nature of endoscopic nasal sampling. • Synthetic MRI and amide proton transfer-weighted MRI could differentiate benign from malignant sinonasal lesions based on quantitative parameters. • The diagnostic efficiency could be significantly improved through synthetic MRI + amide proton transfer-weighted imaging. • The combination of synthetic MRI and amide proton transfer-weighted MRI is a noninvasive method to evaluate sinonasal lesions.

Role of magnetic resonance imaging in sinonasal pathology: a review

The last several years have seen a considerable advancement in the treatment of sinonasal diseases. The advent of minimally invasive functional endoscopic sinus surgery has led to an increased understanding of the anatomy and function of the sinonasal region, making previously inaccessible areas safe to operate in. The advancement in imaging of the sinonasal tract has been associated with the evolution of endoscopic sinus surgery. The imaging of sinonasal pathology has progressed from conventional radiographs (plain films) to computed tomography (CT) and magnetic resonance imaging (MRI). Technological advancements in CT and MRI have given a precise differential diagnosis and greater detail about the anatomical extent of sinonasal pathologies. Because the high water content of the inflammatory state causes a markedly enhanced signal on T2-weighted scans, MRI can currently distinguish between retained secretions and inflammatory responses from the mass of the tumor. The invasive lesions affecting the soft tissues outside of the sinonasal region are more easily distinguished by MRI. MRI largely took the position of CT scan for malignant sinonasal lesions due to its superior capacity to distinguish between inflammation and tumor and its increased sensitivity for intracranial extension. MRI can be more useful than a CT scan in demonstrating the degree of soft tissue abnormalities and in identifying lesions that have returned after surgery.

Histopathologic study of sinonasal lesions: A hospital based retrospective study, from January 2016 to August 2020

Background: Sinonasal area is a host to various neoplastic and non- neoplastic lesions. The presenting symptoms of sinonasal lesions are similar and pose difficulty for diagnosis based on clinical features and advanced imaging modalities, which makes histopathology the principal diagnostic tool approach for these lesions. The aim of this study is to determine the various histopathologic types of Sinonasal lesions, their classification and relative distribution with regards to age and sex in our setting. Materials and Methods: A retrospective cross-sectional descriptive study conducted on 306 cases of sinonasal lesions over the period from January 2016 to August 2020. All the sinonasal tissues were received and diagnosed at histopathology section of Department of Pathology in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. The Pathology reports were collected from the pathology data archives; and the variables of study were extracted by using a data extraction sheet, and data analysis was done using SPSS version 26.0. Results: Most affected age group was 21-30 years 81(26.5%). Male predominance was observed with M: F ratio of 1.4:1.Nasal cavity was the commonest anatomical site involved 237(77.5%).There were 137(44.8%) Non-neoplastic lesions and 169(55.2%) Neoplastic lesions. Inflammatory Sinonasal Polyps 100(73.0%) were the most common among non-neoplastic lesions; inverted Sinonasal Papilloma 34(41%) the most common among the benign neoplastic and squamous cell carcinoma and nasopharyngeal carcinoma accounting for 21(25.6%) cases each, were the commonest malignant lesions. Conclusion: clinical findings and advanced image modalities can reach to a presumptive diagnosis for the sinonasal lesions but histopathology remains the gold standard for categorizing and diagnosis of non-neoplastic and neoplastic lesions of sinonasal tract.

Nasal and sinonasal tumors formed by atypical adenomatous lesions arising in respiratory epithelial adenomatoid hamartoma/seromucinous hamartoma.

Two benign adenomatous lesions are commonly recognized within the sinonasal tract, namely respiratory epithelial adenomatoid hamartoma (REAH) and seromucinous hamartoma (SH). We present 10 hitherto unrecognized benign polypoid nasal and sinonasal tumoriform lesions having in average 3.6cm in largest dimension, which are histogenetically related to SH and REAH. In addition to typical structures of REAH and SH, these lesions contained an additional characteristic and slightly atypical adenomatous component, which we termed atypical sinonasal glands arising in SH (ASGSH). ASGSH often produced deep red colored secretion with peripheral clearing similar to that seen in thyroid follicles. In contrast to SH, ASGSH was endowed by both secretory and myoepithelial layers and had mostly angulated shapes with snout-like protrusions into the lumens. Both layers were formed by an irregular, disorganized, and often incomplete cell lining, which had slightly atypical cytological features without mitoses. In 3 cases, ASGSHs revealed sebaceous differentiation, and in 3 cases the stroma produced a well-differentiated cartilage. Neoplastic nature of ASGSH was supported by finding of various mutations as revealed by next generation sequencing in five cases. In two cases each, we found identical mutations in BRAF gene (Val600Glu), and RET gene (Arg912Trp), respectively and in one case FAT1 gene alteration (Pro1665Leu).

Cats with idiopathic chronic rhinosinusitis that develop clinical signs before two years of age have more severe nasal conchal lysis, sinus malformation, and more severe inflammation on histological examination.

To evaluate the severity of sinonasal lesions on CT in cats with feline idiopathic chronic rhinosinusitis (FICR) comparing cats who developed the condition at a young age to those who developed it as an adult. And, to assess if CT findings correlate with histopathology. 58 cats with FICR confirmed on histopathology. Medical records were retrospectively reviewed. Cats were divided into 2 groups based on their age category: juvenile (group 1, n = 30) and adult (group 2, 28), with juvenile cats being 2 years old or younger and adults being older than 2 years at the onset of clinical signs. Computed tomographic findings were recorded and graded (mild, moderate, and severe) by a board-certified radiologist, comparing each group. The CT findings were then compared to the histopathology results. The overall CT grade was not significantly different between the 2 groups (P = .21). Nasal conchal lysis was more severe in group 1 than in group 2 (P = .002), and group 1 also had a higher incidence of sinusal malformation (OR 2.42). Inflammatory infiltrates were more severe on histopathology in group 1 than in group 2 (OR 4.95), and the overall CT grade was slightly positively associated with the histological severity (κ = 0.2). Feline idiopathic chronic rhinosinusitis was associated with more severe nasal conchal lysis, sinus malformation, and more severe inflammation on histopathological examination in cats that develop clinical signs before 2 years of age. This finding could have an impact in term of clinical signs severity.

Histopathological study on the spectrum of various sinonasal lesions

Abstract Background: A variety of neoplastic and non-neoplastic conditions involve the nasal cavity and paranasal sinuses, amongst which the prevalence of non-neoplastic sinonasal lesions in the general population is 1-4%. It can give rise to a very diverse assay of neoplasms i.e., about 1% of all malignancies. Methods: The study was conducted in the Department of Pathology Mahadevappa Rampure Medical College over a period of two years (2019-2021). A total of 30 cases of sinonasal tract lesions were identified and their histopathological examination was carried out and special staining was done wherever necessary. Results: Out of 30 sinonasal cases, 16 lesions were inflammatory, seven lesions were benign neoplastic lesions and the other seven were malignant. Nasal polyps were the most common inflammatory lesions, mostly in females. Out of seven malignant lesions, squamous cell carcinoma was found in three lesions, and in benign lesions, sinonasal papillomas were found in five lesions. Conclusion: Various lesions of the sinonasal tract including non-neoplastic, benign, and malignant can occur in any age group and both sexes.

Evaluation of narrow-band imaging in the diagnosis of sinonasal inverted papilloma.

Narrow-band imaging (NBI) can be used to differentiate benign sinonasal lesions NBI can be used in the preoperative identification of sinonasal inverted papilloma Future studies can focus on NBI for recurrent inverted papilloma and surgical margin guidance.

Sinonasal lesions – Case analysis at a tertiary care centre in coastal India

Sinonasal lesions – Case analysis at a tertiary care centre in coastal India

A clinicopathological study of sinonasal lesions-5 years study in a rural hospital setup

Background: Sinonasal lesions of both non-neoplastic and neoplastic variants are frequently observed by clinicians in the nasal cavity and paranasal sinuses. Sinonasal lesions are important due to divergence in their behavior and prognosis. Hence, a careful histological workup remains the mainstay of a final definitive diagnosis and timely intervention. Materials and methods: A prospective analysis was done on 151 patients of Sinonasal masses who presented to the Department of Otorhinolaryngology, MVJ Medical College and Hospital, from 2014 to 2019. Their biodata, clinical profile, and histopathological diagnosis were analyzed. Results: Non-neoplastic lesions (135 cases, 89.4%) were more frequent than neoplastic lesions (16 cases, 10.59%), and showed male predominance with an M: F ratio of 1.7:1. Nasal polyp (119 cases, 88%) was the most common lesion. Nasal obstruction (89 cases 89.45%) was the most common presenting feature. Among the neoplastic lesions, lobular capillary hemangioma was the most common benign lesion (2 cases,50%), and squamous cell carcinoma 2 cases (18.1%), was the most common malignant lesion. Conclusions: Sinonasal masses can present with overlapping clinical features, hence, it is important to categorize them into non-neoplastic and neoplastic lesions for further management. Histopathology remains the gold standard for establishing the diagnosis in such cases.

Postoperative Pain Following Coblation of Sinonasal Hereditary Hemorrhagic Telangiectasias.

Hereditary hemorrhagic telangiectasia (HHT) is a rare, autosomal dominant disease and epistaxis is the most common symptom. This can be treated conservatively but severe cases may require operative interventions. Endoscopic endonasal coblation of HHT lesions has been used successfully but postoperative pain management has not been well described. This study aimed to assess levels of postoperative pain and opioid use among patients with HHT who underwent coblation of sinonasal lesions. This is a longitudinal, prospective cohort study of adult patients undergoing endoscopic endonasal coblation for treatment of HHT lesions with or without bevacizumab injection between November 2019 and March 2020 at a single academic university hospital. Patients were given preoperative questionnaires and contacted via telephone 48 hours after surgery. If they reported using opioids for pain control, they were called every 2 days until they no longer used these medications. Fourteen cases, including 13 unique patients, were included in this study. Opioids were ordered on discharge in 4 cases and the average morphine milligram equivalent prescribed on discharge was 41. The median pain score on postoperative day (POD) 2 was 4 of 10. Twelve patients reported using acetaminophen and 4 were using opioid pain medications. Of those using opioid pain medications, only 1 patient was using opioid pain medication by POD 4 and denied any use after POD 10. This study is the first to analyze postoperative pain management and opioid prescribing patterns in HHT patients undergoing endonasal coblation of telangiectasias. Postoperative pain was mild to moderate and most patients stopped using opioid medications by POD 4, although the majority of patients solely used acetaminophen. Future studies with increased sample size will be useful to further identify predictors of need for analgesics postoperatively and other non-opioid adjuncts for pain control.

An atypical Esthesioneuroblastoma of the sphenoid sinus: a case report.

A 27-year-old male patient with no medical history, complained of a headache, a unilateral right nasal obstruction, epistaxis, and anosmia for 2 months. Nasal endoscopy showed a pinkish-gray mass filling the right nasal cavity. An enhanced-contrast CT scan was performed and objectified a mildly enhancing extensive mass of the sphenoid sinus with bone erosion of the left wall of the sinus and intracranial involvement. An intranasal biopsy was performed, resulting in a histopathological diagnosis of olfactory neuroblastoma. Our case was staged as stage C according to the Kadish staging. The tumor was inoperable, the patient had chemotherapy, radiotherapy, and pain management. ENB is an aggressive malignant tumor derived from the specialized olfactory neuroepithelium of the upper nasal cavity. Several published reports confirm ectopic cases of ENB throughout the nasal cavity and the central nervous system. Because sinonasal malignant lesions are rare and difficult to distinguish from their benign counterparts. ENBs appears as a soft, glistening, polypoidal, or nodular mass covered by intact mucosa or as friable masses with ulceration and granulation tissue. A radiological, CT scan through the skull base and paranasal sinuses with intravenous contrast should be performed. ENBs are solid, enhancing nasal cavity masses that may manifest erosion into nearby osseous. MRI provides better discrimination between tumor and secretions and optimal assessment of orbital, intracranial, or brain parenchymal involvement. The biopsy is the next important step in securing a diagnosis. Classic treatment strategies of ENB are based on surgery or radiotherapy as unique modalities or a combination of surgery and radiation therapy. More recently, chemotherapy has been introduced in the therapeutic armamentarium since ENB has proven to be chemosensitive. The elective neck dissection remains controversial. Long-term follow-up is mandatory for patients with ENB. While most ENBs originate in the superior nasal vault and present with typical symptoms of nasal obstruction and epistaxis in the late stages of the disease, uncommon manifestations should be considered as well. Adjuvant therapy should be considered in patients with advanced disease and unresectable disease. A continuing follow-up period is needed.

Sinonasal Organised Haematoma- A Case Report and Review of Literature.

Sinonasal organised haematoma (SOH) is an uncommon, benign condition that can be locally aggressive. SOH can be mistaken for a malignant tumour but the characteristic imaging findings and histopathology facilitate the diagnosis of an organised haematoma. We report a 26 year old male patient presenting with unilateral nasal obstruction and painless epistaxis, which are the most common presenting symptoms of sinonasal tumour lesions. Based on the clinical features, age, radiological investigation, intraoperative finding, location of the lesion and histopathological examination; a diagnosis of SOH was arrived at. Surgical excision utilized the COBLATION technology and endoscopic complete removal of the nasal mass was done. Intraoperatively minimal bleeding was encountered. On histopathology, haematoma at the center and fibrosis at the periphery was noted. To our knowledge, this is the first reported case of SOH excision using Coblator. No recurrence was seen in subsequent follow ups. Although SOH can be mistaken for a malignant tumour, the characteristic imaging and histopathology findings facilitate the diagnosis of an organised haematoma.

Texture analysis of diffusion kurtosis imaging for differentiating malignant from benign sinonasal lesions: added value to conventional imaging features.

To evaluate the performance of texture analysis (TA) of diffusion kurtosis imaging (DKI) in differentiating malignant from benign sinonasal lesions, and its added value to the conventional imaging features. Fifty-eight patients with malignant and 40 patients with benign sinonasal lesions were retrospectively enrolled. Conventional CT and MRI features were reviewed. Texture parameters were obtained and compared between two groups. Multivariate logistic regression analysis was used to identify the most valuable variables. Receiver operating characteristic curves were performed to assess the differentiating performance of independent variables and their combination. There were significant differences in tumor necrosis, bone erosion and soft tissue invasion between the two groups (all p < 0.05). There were significant differences in the 10th and entropy of Apparent diffusion coefficient map, the mean, 10th and entropy of D map, the mean and 90th of K map between the two groups (all p < 0.002). The bone erosion, entropy of D, and mean of K were independent variables associated with malignant tumors. Receiver operating characteristic analyses indicated that the combination of three features possessed better differentiating performance than bone erosion alone (p = 0.003). TA of DKI could supply incremental value to conventional imaging features for pre-operative differential diagnosis between benign and malignant sinonasal lesions. The present study is the first to combine conventional imaging features and the TA of DKI in the differential diagnosis between benign and malignant sinonasal lesions. Our findings suggest that TA of DKI could supply incremental value to conventional imaging features.

Chondroblastoma- a rare sinonasal tumor: case report and review of literature

Chondroblastoma is a benign primary bone tumor that typically develops in the epiphyses of long bones. Chondroblastoma of the craniofacial skeleton is extremely rare, with most cases occurring in the squamosal portion of the temporal bone. In this report, we describe a case of chondroblastoma of the nasal cavity presenting with a left sided nasal mass which was excised with open approach. We review the literature on craniofacial chondroblastomas with particular emphasis on sinonasal lesions.

Sino-nasal and pharyngeal mass- Immunohistochemistry cuts the gordian knot

Sinonasal and pharyngeal mass lesion of Extraskeletal Ewing sarcomas (EEWSs) are extremely rare. Herein we present a case of EEWSs of ethmoid sinus extending into nasal and pharyngeal spaces mimicking as angiofibroma clinically. Histopathological examination in conjunction with immunohistochemistry puzzled out the diagnostic dilemma.

Histopathological Analysis of Sinonasal and Nasopharyngeal Lesions- A Retrospective Study

Introduction: Sinonasal and nasopharyngeal lesions is a common problem in the present environment with diagnostic and therapeutic dilemma. Majority of the lesions present clinically as polypoid masses. Histopathological examination of these lesions is essential for the definitive diagnosis because management and prognosis vary among different lesions. Aim: To determine the incidence of various nasal lesions reported in a rural tertiary care hospital, and to compare these lesions in relation to demographic data of the patients. Materials and Methods: This retrospective study was conducted on the specimens received at histopathology section from the ENT department of a tertiary care hospital from April 2018 to November 2021. The specimens were fixed in 10% formalin, processed and then stained with haematoxylin and eosin. Required data were obtained from the histopathology records. Results: The present study was conducted on a total of 100 cases. Amongst these, 61 were males and 39 were females. An overall male predominance was noted. Maximum numbers of cases were diagnosed in the age group 31-40 years. Non neoplastic constituted N=86 cases (86%), neoplastic benign lesions constituting N=10 cases (10%) and malignant masses constituted N=04 cases (04%) of the total lesions in the present study. Inflammatory polyps were the most commonly diagnosed cases and few fungal rhinosinusitis in postCOVID-19 patients were noted in the present study. Inverted papillomas were predominant benign neoplastic lesions whereas nasopharyngeal carcinomas were noted as predominant malignant lesions. Conclusion: Most of the sinonasal and nasopharyngeal lesions reported were non neoplastic and inflammatory polyp being most common. Malignant lesions were reported in advanced age of life.