Abstract
Objective: 1) Determine the frequency and clinical relevance of unanticipated histopathologic results in routine sinonasal surgery. 2) Evaluate the necessity for histopathologic processing of septal cartilage, bone, and inferior turbinate specimens during routine sinonasal surgery.
Method: A retrospective review of histopathologic reports on all adult patients undergoing sinonasal surgery at a tertiary care hospital during a 5-year period from 2005 to 2010 was performed. All cases with the preoperative diagnosis of sinonasal neoplasia, autoimmune disease, or directed septal biopsies were excluded from review.
Results: A total of 1198 pathology reports were reviewed from 1175 individual patients. This included histopathologic evaluation of 1194 septal cartilage and bone specimens and 715 inferior turbinate specimens. None of the patients had an unanticipated histopathology finding other than squamous metaplasia and inflammation.
Conclusion: Many surgeons obtain histopathologic diagnoses on all tissue removed from a patient. Based on our extensive review, histopathology of the septum and inferior turbinates in routine sinonasal cases may not be necessary. In the current era of cost-containment in medicine, using a value-based approach to processing routine tissue by waiving histopathologic evaluation could provide significant cost savings.
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