Objective:

To evaluate the usefulness of an Index of Suspicion Scale (ISS) based on the endoscopic and imaging correlation of the findings commonly observed in patients with conclusive histopathological confirmation of sinonasal papilloma (SPs).

Study Design:

Retrospective and correlational study.

Material and Methods:

A cohort of 103 consecutive patients with confirmed histopathological diagnosis of SPs were analyzed during the period 2000-2019, in which the endoscopic and radiological features were evaluated through a bimodal CT/MRM protocol, with whose uncovering a correlative scale of findings was developed that can allow to deduce its diagnosis.

Results:

All patients with SPs had endonasal polypoidal masses, of which only 91% of the cases showed opacified tomographic images coinciding with the endoscopic finding. Focal hyperostosis was observed in 79% patients. Sinonasal bony wall erosion was observed in 84%. Contoured cerebriform pattern images were identified in 86% of T1-weighted and T2-weighted MRI studies. Correlation of endoscopic and imaging findings, based on sensitivity measures and positive predictive values, showed results of diagnostic probability and reliability with an overall average global mean of 90%. The SPs assessment criteria in the proposed SIS considered all above-mentioned findings. Through this correlative scale, 19% of patients were detected with early SPs (low suspicion), 31% were found to have moderately growing SPs (moderate suspicion) and 50% were identified with SPs of greater size (high suspicion).

Conclusion:

The proposed ISS was able to allow a satisfactory clinical diagnosis of SPs. The correlation of the clinical criteria considered proved that it can be a useful guide in the timely clinical assessment of these neoplasms.

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