Benign tumors of the nasal cavity are a group of neoplasms of the nasal cavity that have different tissue origin and are distinguished by the absence of ulceration and metastasis of the tumor. Tumors of the nasal cavity are manifested by a violation of the perception of odors, difficulty in nasal breathing, mucopurulent discharge from the nose, a feeling of a foreign body in the nose, headache. In the diagnosis of benign tumors of the nasal cavity, the main data are histological studies and rhinoscopy. The prevalence of the tumor process can be assessed by pharyngoscopy, radiography (the nasal sinus is examined), CT of the skull, ophthalmological examination, CT and MRI of the brain. The treatment of nasal tumors consists of electrocoagulation, excision, sclerosing, laser destruction.
The content of the article:
Causes of benign tumors of the nasal cavity
Symptoms of benign tumors of the nasal cavity
Diagnosis of benign tumors of the nasal cavity
Treatment of benign tumors of the nasal cavity
Prognosis of benign tumors of the nasal cavity
Benign tumors of the nasal cavity
In otolaryngology, benign tumors of the nasal cavity are observed in patients of any age. If we talk about children, they are dominated by tumors of a congenital nature, which are associated with the occurrence of abnormalities in the process of intrauterine development and disorders of differentiation of the rudimentary embryo. These can be angiomas, dermoid cyst, ganglioneuroma, chordoma. Among other benign tumors of the nasal cavity there are bleeding polyp, chondroma, papilloma, osteoma, fibroma, lipoma, adenoma, myxoma.
Causes of benign tumors of the nasal cavity
The occurrence of congenital benign tumors of the nasal cavity is caused by various exogenous and endogenous teratogenic effects (medications, alcohol, nicotine, etc.) on a woman during pregnancy. The formation of tumors begins in the prenatal period.
In adults, the trigger factors for the appearance of benign nasal tumors are adverse long-term effects on the nasal mucosa. This occurs under the influence of a chronic allergic nasopharyngeal disease (pollinosis, allergic rhinitis) or infectious (sinusitis, chronic rhinitis, sinusitis, adenoids, rhinopharyngitis) genesis. Also, the development of nasal tumors is provoked by frequent injuries to the nose and its mucous membrane, inhalation of various irritating substances (for example, in workers of the pharmaceutical or chemical industry), dustiness or smoke in the workplace.
Symptoms of benign tumors of the nasal cavity
At the beginning of their development, benign tumors of the nasal cavity are almost asymptomatic. Clinical manifestations occur when the tumor begins to interfere with the normal flow of air into the nasopharynx, since it has reached a significant size. At the same time, the patient experiences difficulty in nasal breathing. In most cases, it is after this that people decide to seek help from an otolaryngologist. In addition, there is a decrease in the susceptibility of odors (hyposmia), nosebleeds (their intensity depends on the nature of the tumor), a feeling of a foreign body in the nasal cavity.
The addition of a secondary infection with the development of rhinosinusitis or rhinitis often occurs, as there is a violation of the ventilation of the nasal cavity. Patients with benign tumors of the nasal cavity in such cases complain of mucopurulent or mucous discharge from the nose, pain in the inflamed sinus area, headache and the like.
Infiltrative growth and the ability to spread into the pharynx, paranasal sinuses, brain, orbital cavity affect some benign tumors of the nasal cavity — osteoma, chondroma, angioma. The proliferation of these tumors affects the pharynx, therefore it has similar symptoms with benign tumors of the pharynx — breathing problems and swallowing disorders (dysphagia).
The development and germination of the tumor into the orbit is characterized by diplopia, exophthalmos, narrowing of the visual fields, decreased visual acuity, limited mobility of the eyeball.
In turn, the spread of the tumor of the nasal cavity to the structures of the brain is accompanied by unilateral flattening of the nasolabial fold, increased headache, disorders of the cranial nerves, epileptic seizures and a number of other symptoms.
Chondromes and osteomas often grow into bone structures that form the walls of the paranasal sinuses and the nasal cavity. As a result, this leads to their destruction. The clinical picture of benign tumors of the nasal cavity observes various facial deformities and curvature of the nasal septum.
Diagnosis of benign tumors of the nasal cavity
Only an otolaryngologist can diagnose benign nasal tumors. To do this, a rhinoscopy is performed, which allows you to consider the formation and differentiate it from a foreign body or from a scleroma. Also, the doctor will see the appearance of the tumor, so that he can determine it. Benign tumors of the nasal cavity in the early stages are asymptomatic, so quite often they are discovered accidentally during rhinoscopy for the second diseases. Difficult to diagnose formations need to be further investigated using an endoscopic biopsy, not to mention consulting an oncologist.
In benign tumors of the nasal cavity, olfaction is detected during olfactometry. To study the degree of tumor development and its spread to other structures, pharyngoscopy, radiography and CT of the skull, radiography of the paranasal sinuses, CT and MRI of the brain, exophthalmometry, consultation of an optometrist with visual acuity testing, ophthalmoscopy (examination of the fundus) and determination of visual fields are performed. In the presence of an infectious process, a smear from the nasal cavity and pharynx is taken to identify pathogenic microflora.
Treatment of benign tumors of the nasal cavity
Benign tumors of the nasal cavity due to the danger of overgrowth and malignancy, violation of normal respiratory function must be removed using a surgical method. Surgical intervention can stop the presence of chronic decompensated diseases (coronary heart disease, heart failure, severe hypertension, bronchial asthma, respiratory failure, diabetes mellitus, cirrhosis of the liver, kidney failure) and the elderly age of the patient.
The method of removing a benign tumor of the nasal cavity directly depends on its nature of growth, size and type. The structure of the tumor and the tissue it affects also play a role.
Small adenomas, papillomas and fibroids are removed under local anesthesia by endoscopic method using an electrocoagulating loop. In the case of a bleeding nasal polyp, the tumor must be removed along with the part of the nasal septum to which it is attached. The base of the tumor is cauterized by electrocoagulation or cryoprocessing. Thus, it is possible to prevent relapses.
Large benign tumors of the nasal cavity are removed with a radio-wave knife, laser or scalpel. During the operation, a surgical microscope is used to clearly differentiate tumor cells from surrounding tissues.
If we talk about vascular benign tumors of the nasal cavity of small sizes, they are removed by cryodestruction, electrocoagulation or using a laser. Removal of large angiomas can cause severe bleeding. In this regard, before the operation, the carotid arteries are pre-bandaged. If the tumor grows deep into the surrounding tissues, the tumor is sclerosed or occlusion of the vessels feeding it is applied.
Chondromes and osteomas, which grow into structures adjacent to the nose and into the bone walls, quite often doctors have to remove in parts. For this purpose, not only endonasal, but also external surgical accesses are used. In some cases, the operation may be triggered by resection of bone structures. Also, the appearance of facial defects is not excluded, since the volume of tissues will increase. In such situations, it is necessary to carry out reconstruction using plastic surgery methods.
Prognosis of benign tumors of the nasal cavity
As practice shows, a large number of benign tumors of the nasal cavity are not prone to malignancy and are characterized by slow non-invasive growth. Thanks to this, doctors give a positive prognosis for further full recovery of the patient. Moreover, modern medicine has various tools for conducting successful and effective operations.
Postoperative relapses are often accompanied by a bleeding nasal polyp and papilloma. Of all the benign tumors of the nasal cavity, the most unfavorable are chondromas and osteomas. This also applies to chondrosarcoma and osteosarcoma, which are prone to malignancy and cause destruction of surrounding tissues.
Removal of osteomas and chondromes is accompanied by extensive tissue defects, the development of hoan atresia, the formation of synechiae in the nasal cavity, and the like. Under the influence of these factors, there is a persistent violation of nasal breathing and a complete loss of sense of smell.
Doctors recommend that at the first manifestations of benign tumors in the nasal cavity, immediately consult a specialist to prevent their development and start treatment in a timely manner.
