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Endoscopic endonasal resection of respiratory epithelial adenomatoid hamartomas of the sinonasal tract

Bignami, Maurizio and Volpi, Luca and Karligkiotis, Apostolos and De Bernardi, Francesca and Pistochini, Andrea and Al Qahtani, Abdul Aziz and Meloni, Francesco and Verillaud, Benjamin and Herman, Philippe and Castelnuovo, Paolo (2014) Endoscopic endonasal resection of respiratory epithelial adenomatoid hamartomas of the sinonasal tract. International Forum of Allergy & Rhinology, Vol. 4 (12), p. 961-965. eISSN 2042-6984. Article.

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DOI: 10.1002/alr.21372

Abstract

Background
Respiratory epithelial adenomatoid hamartomas (REAHs) are rare benign tumors and may manifest as either isolated lesions or in association with sinonasal polyposis. The aim of this study is to report our experience in the management of patients with REAH and to analyze the long-term results of the endoscopic endonasal approach.
Methods
A retrospective analysis of a database dedicated to patients with REAH treated between May 2003 and December 2012 was performed. Clinical presentation, demographic, histologic and radiographic features, operative findings, and follow-up data were examined.
Results
Twenty-seven patients with REAH, 14 males and 13 females, with a mean age of 51 years, underwent endoscopic sinus surgery (ESS). The most frequent reported symptoms were nasal obstruction (80%), headache (12%), mucous rhinorrhea (20%), and hyposmia (40%). Seventeen cases (first group) were present as isolated masses, 10 cases (second group) were associated with nasal polyposis. The first group with a preoperative diagnosis of REAH was submitted to a more aggressive resection with subperiosteal dissection and drilling of the underlying bone. The patients in the second group, because of the unrevealed diagnosis of REAH and due to the presence of nasal polyposis, underwent standard ESS. No evidence of recurrence in either of the subgroups after a mean follow-up of 61.2 months.
Conclusion
REAH is a benign well-defined pathological entity but is still unfamiliar. REAH should be kept in mind as a differential diagnosis from more aggressive lesions to avoid unnecessary surgical procedure. A complete but conservative endoscopic resection appears to be curative.

Item Type:Article
ID Code:10395
Status:Published
Refereed:Yes
Uncontrolled Keywords:Respiratory epithelial adenomatoid hamartomas, paranasal sinus, endoscopic endonasal, endoscopic sinus surgery, ESS, REAH
Subjects:Area 06 - Scienze mediche > MED/31 Otorinolaringoiatria
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze Chirurgiche, Microchirurgiche e Mediche
Publisher:Wiley
eISSN:2042-6984
Deposited On:26 Nov 2014 11:35

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