Neoplasia

 new, uncontrolled growth of cells that

is not under physiologic control.

A "tumor" or "mass lesion"

"growth" or "enlargement" which may
not be neoplastic (such as a granuloma).

 The term "cancer“= malignancy

but neoplasms can be subclassified as
either benign or malignant.
NEOPLASMA THT
 TELINGA :
 Neuroma Akustik
 HIDUNG dan SINUS
 Tumor Sinus
 Polip Nasi
 Tumor Nasofaring
 TENGGOROK
 Tumor Tonsil
 Non Hodgkin Limfoma
 Tumor Laring
 KEPALA LEHER
 Tumor parotis
 Tumor tyroid,
Tumor
 Diagnosis
 Lokasi
 Jenis tumor
 Metastase
 (T-N-M)

 Terapi
 Operasi
 Radiasi
 Kemoterapi
 KARSINOMA NASOFARING

 POLIP NASI
Karsinoma nasofaring
Karsinoma nasofaring
Karsinoma nasofaring
Karsinoma nasofaring
Karsinoma nasofaring
Definition
 Nasal polyp: inflammatory
mucosal protrusion from the nasal
and/or sinus cavities
 Aetiological Predisposing Unknown
factors factors causes
- Aspirin intolerance - Allergic reaction
- Cystic fibrosis (Type I -Ig E mediated)
- etc.

Nerve damage Mast cell degranulation

Vasomotor denervation Mediator release

Gland denervation Histamine release

Chronic inflammation of nasal mucosa

Hypersensitivity of mucosal vascular bed

Increased vascular permeability

Repeated vasomotor reaction

Repeated edema

Accumulation of inflammatory exudate

Collagen fibrils lose stability
New blood vessels formation
Young connective tissue formation

Increased thickness of mucosal edema

Polyps formation
Classification of nasal
polyp
Clinical presentation Histological
 1. Simple polyps
 2. Nasochoanal or
antrochoanal polyps
 3. Nasal polyps with
asthma and aspirin
intolerance (ASA triad)
 4. Nasal polyps associated
with systemic diseases
 5. Allergic fungal sinusitis
findings
 1. Allergic polyp
(Eosinophilic)
 2. Fibroinflammatory
polyp (Neutrophilic)
 3. Polyp with glandular
hyperplasia
 4. Polyp with atypia
Grading system for nasal
polyp
 Grade I Confine in middle meatus
 GradeII Prolapse into nasal cavity,
Not reaching the lower end of inf.
turbinate
 GradeIII Reaching the floor of nasal
cavity
 Characteristic of nasal
polyp
 Typical nasal polyps: bilateral
 Polypoidal, soft, semi-translucent
 Whitish grey or yellow in color
 Smooth glistening surface
 Mobile, Non-painful
 Unresponsive to topical
decongestants
Endoscopy
Differential diagnosis of
nasal polyp

 Unilateral nasal mass

 1. Hypertrophic/polypoid turbinate
 2. Antrochoanal polyps
 3. Mucocele
 4. Benign tumors: Inverted papilloma,
Angiofibroma
 5. Malignant tumors: SCC, Adenocarcinoma
ANTROCHOANAL POLYPS
Frontal Mucocele
Medical polypectomy

 1. For polyps grade I-II

 2. Prednisolone 20-40 mg/day 1-2 weeks
 3. Topical nasal steroid spray for 3 months
 4. Treatment of sinusitis
 5. Treatment of allergic rhinitis
Surgical treatment

 For polyps grade III or

failure of medical treatment
 1. Snaring and inferior antrostomy
 2. Intranasal ethmoidectomy
 3. Caldwell-Luc operation
 4. Functional Endoscopic Sinus Surgery
(FESS)
 CALDWELL-LUC OPERATION
CWL
ENDOSCOPIC SINUS SURGERY

ESS
ESS :
1.Use the endoscope for magnification and visualization
2. Clear the OM complex
3. Preserve the sinus mucosa as much as possible