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Schneiderian papilloma is a benign sinonasal tumour, which has three morphological variants: fungiform, inverted and oncocytic. Inverted papilloma, being the most prevalent variant, is three times more common among males in their fifth to seventh decade of life. On the other hand, nasopharyngeal carcinoma is a malignant tumour arising from the nasopharyngeal epithelium. Albeit rare, synchronous sinonasal tumour has been reported and remains a quandary till date, especially when it involves malignant and benign synchronous nasal mass. In this paper, we reported a case of a successfully treated synchronous sinonasal inverted papilloma with nasopharyngeal carcinoma in an elderly male. We would like to highlight the need to investigate suspicious bilateral nasal masses due to the possible coexistence of two different pathologies, as in our case.

Aim: The aim of the study was to outline the longitudinal outcomes of olfactory dysfunction amongst patients with coronavirus disease 2019 (COVID-19) in a single tertiary centre in Malaysia. Materials and methods: Adults patients who tested positive for COVID-19 via reverse transcription-polymerase chain reaction and were admitted to Hospital Sungai Buloh, Malaysia, were recruited in this study. The patients completed a questionnaire via telephone interview comprising the following details: age, sex, ethnicity, comorbidities, general and otorhinolaryngological symptoms, and onset and duration of olfactory and gustatory dysfunction. The patients with persistent olfactory and gustatory dysfunction at the time of the initial interview were followed up every 3 to 5 days until resolution. Results: A total 185 patients were included in this study out of 378 patients contacted. Ninety patients reported olfactory dysfunction symptoms, with 59 of them complaining of anosmia. The mean age of the participants was 39.52 years (age range: 18–66 years). More than half of the patients with olfactory dysfunction had no comorbidities (55.56%). Of the 90 patients with olfactory dysfunction, 66 patients (73.3%), including 40 males and 26 females, regained their olfactory function completely within 2 weeks. The remaining 24 patients were contacted after 4, 8, and 12 weeks. Ten patients (11.1%) were found to have recovered their sense of smell after one month, while 5 patients (5.56%) recovered within 2 months, and 1 patient (1.11%) recovered in 3 months. Conclusion: Complete recovery was noted in 73% of the patients within a period of 2 weeks, whereas persistence of symptoms was noted in 6 patients (6.67%) after 3 months.

Aim: To highlight the challenges involved in the diagnosis and management of synchronous tumours. A synchronous head and neck lesion brings the attending physician into a quandary, as there is no gold standard for managing such patients. Failure to respond to treatment should provoke physicians into considering other possible diagnoses, as often a secondary lesion may be the hidden culprit. Case report: Herein, we present a case of a synchronous cervical mass: Kimura disease and nasopharyngeal carcinoma in a 48-year-old woman. She was initially treated for Kimura disease based on fine-needle aspiration cytology evidence, and later found out to have a synchronous malignancy in the fossa of Rosenmüller. Failure of Kimura disease to respond to steroid treatment led to a repeated examination, which resulted in the diagnosis of nasopharyngeal carcinoma. The patient was treated with concurrent chemoradiotherapy. Conclusion: Kimura disease, a rare benign head and neck tumour, is treated successfully with steroids. Persistent swelling coupled with treatment failure should alert physicians to repeat patient assessment, as improper disease management leads to severe complications.

Aim: To highlight the possibility of synchronous benign and malignant nasal masses. Schneiderian papilloma, also known as inverted papilloma, despite being a common benign epithelial sinonasal tumour, remains a conundrum to otorhinolaryngologists due to its locally aggressive nature, tendency to recur as well as potential of malignant transformation. A synchronous nasal lesion adds on to the complexity of patient management. Case presentation: Herein, we are reporting an unusual case of synchronous lesions: sinonasal inverted papilloma and low-grade mucoepidermoid carcinoma. Initial biopsy of the sinonasal mass revealed inverted papilloma. However, histopathological examination post endoscopic medial maxillectomy revealed evidence of both inverted papilloma and low-grade mucoepidermoid carcinoma. Conclusion: We want to highlight that seemingly benign sinonasal inverted papillomas ought to be taken seriously considering the possibility of a synchronous malignant nasal mass, as in our case.

Aim of the study: To outline the challenge faced in diagnosing intramuscular haemangioma of the masseter in a child. Intramuscular haemangioma is an unusual type of haemangioma and is oftentimes overlooked or misdiagnosed by health care professionals. Case report: Herein, we discuss a complex case of a 9-year-old girl referred to otorhinolaryngology department for unilateral preauricular swelling, initially treated as parotitis and finally diagnosed as intramuscular masseter haemangioma following imaging and biopsy. However, the patient had to complete several courses of antibiotics and fine needle aspiration, which was inconclusive, for almost a year prior to attaining diagnosis. Conclusion: We would like to highlight early imaging and image-guided biopsy especially in children to avoid delay in diagnosis and prompt management.

Aim of the study: The aim of this case presentation is to emphasise the importance of meticulous history-taking and physical examination, and increase the awareness of various possibilities for the diagnosis and management of patients with unilateral cheek swelling. Maxillary mucocele is a rare benign cystic lesion of paranasal sinuses. It may be associated with varying symptoms, and patients commonly present with compression symptoms during their first visit, as the maxillary sinus is adjacent to vital structures, notably the orbit and skull base. Case report: Herein, we present the case of a middle-aged man who presented with painless unilateral cheek swelling that turned out to be maxillary mucocele. Conclusions: Presentation of maxillary mucocele often mimics cancerous lesion types. Thorough assessment and proper imaging help to guide otorhinolaryngologists towards making an accurate diagnosis and initiating prompt management.

Aim of this case: To highlight the presentation of rapidly enlarging parotid haemangioma in three children who were all successfully managed with oral propranolol. Case report: Parotid haemangioma in infancy, albeit rare, has been vastly reported due to it being the most common tumour of the salivary gland in infants. Despite that, the presence of a rapidly enlarging tumour in “the little ones” may be daunting, leading to countless unwarranted procedures by attending physicians. Herein, we present three cases of infantile rapidly tumefying parotid lesions which were diagnosed clinically with the support of imaging, and successfully managed by promptly initiating oral propranolol. Conclusion: Although several recent reports have been reviewed, the challenges in diagnosis and management of the condition need to be individualised.

Aim of the study: Cholesterol granuloma is a histological entity which consists of granulation tissue in which a large quantity of cholesterol crystals provoke foreign body giant cell formation. Cholesterol granulomas are often found in the middle ear with rare presentation in the paranasal sinus. We would like to highlight the diagnostic challenges and the management of maxillary sinus cholesterol granuloma in a young woman presenting as a unilateral nasal mass. Case study: We report a young woman with cholesterol granuloma of maxillary sinus who initially presented with unilateral nasal obstruction. Rigid nasoendoscopy and imaging were suggestive of an antrochoanal polyp. Ipsilateral functional endoscopic sinus surgery was done successfully. Conclusion: Albeit rare, cholesterol granuloma ought to be considered a differential diagnosis in a sinonasal tumour. This case report highlights the rare presentation of maxillary sinus cholesterol granuloma which ought to be considered a differential diagnosis of a unilateral nasal mass.

Aim of the study: The aim of this case report is to emphasise the importance of meticulous history-taking and examination, and to raise the awareness of various possibilities of diagnosis and management. Unilateral peritonsillar abscess is a common complication of acute bacterial tonsillitis. However, bilateral peritonsillar abscess is considered rare, and only a meagre number of cases has been reported to date in the English medical literature. The challenging part involved in the diagnosis of bilateral peritonsillar abscess is the absence of common physical findings of unilateral peritonsillar abscess. Case report: We present a case of a teenage girl who presented with a history of worsening sore throat, odynophagia and muffled voice, which turned out to be bilateral peritonsillar abscess. Oropharyngeal examination revealed bilateral peritonsillar fullness, and pus was aspirated bilaterally. The patient underwent bilateral peritonsillar incision and drainage, and was discharged well after a few days, with no recurrence. Bilateral peritonsillar abscess can present with usual symptoms, but physical findings may vary. Conclusion: Proper history-taking and meticulous physical examination may direct the physician towards correct diagnosis, and an imaging evaluation is warranted if in doubt, so as to avoid unwanted perilous complications.