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

Objectives Sinonasal respiratory epithelial adenomatoid hamartoma (REAH) is benign lesion characterized by a glandular proliferation with ciliated epithelium.The aim of this study is to report our experience with patients affected by REAH and analyze the long term results of the endoscopic approach in our experience. Methods A restrospective analysis of a database dedicated to patients with REAH treated at the Department of Otolaryngology at the University of Insubria-Varese, Italy and Diderot-Paris, France from May 2003 to Dicember 2012 was performed. Results The patient cohort included 13 males and 13 females, ranged from 24 to 85 years (mean, 51 years), who underwent endoscopic sinus surgery. 10 cases (38.5%) of REAH were found associated with nasal polyposis. 16 cases (61.5%) of REAH presented as an isolated sinonasal mass. The majority of lesions (88.5%) originated in the olfactory clefts. Follow-up ranged from 12 to 126 months (mean 61,2) with no recurrences of REAH. Conclusion REAH is a benign well defined pathological entity but is still unknown to many clinicians and pathologists. Despite its rarity, REAH should be kept in mind as a differential diagnosis of symptomatic sinonasal lesions because misinterpretation could lead to inappropriate aggressive surgical procedure for this benign lesion. The major advantage of the endoscopic approach lies in the outstanding possibility of having a magnified visualization of the site of origin of the mass as well as explore around corners. The complete but conservative endoscopic resection is essentially curative for these lesions.