Search

Background Antrochoanal polyps (ACPs) are pathologically benign nasal swellings. The maxillary sinus is the commonest reported origin. The polyps are usually unilateral and often exit through the progressively widened maxillary sinus ostium to occupy the choana and may reach the nasopharynx. It is a disease of adolescents and young adults who often present with progressive unilateral nasal obstruction. Encountering bilateral antrochoanal polyps is very rare. Case presentation We report a forty years old male who had progressive bilateral nasal obstruction for 8 years associated with hyposmia and intermittent facial pain and headaches. A nasal mass could be seen on anterior rhinoscopy on both sides, more prominent on the left. Endoscopy revealed bilateral masses hanging down the choanae. Computerized tomography scan of the nose and paranasal sinuses demonstrated bilateral nasal polypi and widening of the maxillary sinus ostia. During endoscopic surgical excision of the lesions, polypi were found to dilate the ostia of both maxillary sinuses. The polypi had antral, nasal, and choanal parts typical of antrochoanal polypi on both sides. The histopathology showed the inflammatory nature characteristic of antrochoanal polyp. Postoperatively, the patient’s symptoms resolved dramatically, and he is on continuous regular scheduled follow-up. Conclusion Bilateral antrochoanal polyps can present with nasal obstruction and can be misdiagnosed as sinusitis; radiological and endoscopic features are useful to reach specific diagnosis; what is special about our presentation is that it is an addition to the literature of a rare disease (bilateral ACPs), and we are reporting it in an older age rather than the common younger age of presentation in the literature reports, which is an addition to the demographic data.

Background Sinonasal masses are not an uncommon spectrum of diseases. They are frequently encountered in Sudan, sometimes with variability in modalities across the country. The objective of this study is to document the pattern of sinonasal masses in Sudanese patients and to highlight the knowledge of the modalities, clinical presentations, and management. As a consequence, this will raise awareness especially of the general practitioners and family physicians and hence the community locally and regionally. Early diagnosis and appropriate management can reduce the rate of recurrence, fatal complications, and hence morbidity and mortality. Methods This is a prospective descriptive, comparative hospital-based study conducted from January 2020 to January 2021. All patients with sinonasal masses, who came to Khartoum ENT Teaching Hospital seeking medical advice during the above-mentioned period were included in the study provided they satisfy the inclusion criteria. Enrollment was optional with the right to withdraw at any time. Consent was verbal with the reassurance about the aspect of confidentiality, privacy, and consent of the data. Ethical clearance was obtained from the ethical committee (EDC) SMSB and from the research committee of Khartoum teaching hospital. Analysis was done using a computer and the statistical package of social sciences SPSS V.25 Results A total number of 244 patients were studied. The age group of 21–40 years was the most encountered with the disease (42.6%). Two hundred three patients (83%) had a non-neoplastic disease, (9%) benign neoplastic lesions, and (8%) malignant neoplastic lesions. The non-neoplastic group was dominated by nasal polyposis of which the fungal were the most common (50%). Among benign neoplastic lesions, pyogenic granuloma ranked first (24%). Among malignant neoplastic lesions, squamous cell carcinoma dominated the epithelial origin lesions (71%) and Rhabdomyosarcoma dominated the connective tissue cell types (50%). Nasal obstruction is the most common complaint (94.7%) followed by nasal discharge (64.8%) then anosmia (53.3%). Endoscopic surgery was done in (84.4%) of patients, combined approach endoscopic and open surgery in (5.3%) while open surgery alone was done in 2.5%. Radiation and chemotherapy were used in 2% each, while chemo-radiation was used in (2.5%). The rest of the cases (1.3%) were managed by surgery followed by chemoradiation. Conclusion Patients with sinonasal masses in Sudan especially the age group 21–40 years must be seen in specialized Otolaryngology clinics to pick, diagnose and treat significant diseases in an early stage. Radiology and histopathology are a must in sinonasal swellings to diagnose malignant diseases at an early stage. Nasosinus fungal polyposis being the commonest in non-neoplastic lesions, the commonest among all sinonasal masses added together, and a known reported endemic disease in the country must receive special consideration and investigation for early diagnosis and treatment.

Background Acute sinusitis is not an uncommon disease that manifests with inflammation of the mucosal lining of the paranasal sinuses. It has varied etiologies including viral, bacterial, fungal, and allergic. Anatomical variations, trauma, auto-immunity, diabetes mellitus, and dental procedures are predisposing factors. With the wide variation in the etiological factors, the management could be tricky. This study is quite relevant with the advent of the relentlessly persisting COVID-19 pandemic which affects the upper respiratory tract as well. Methods This is a descriptive hospital-based prospective study conducted at the Khartoum ENT Teaching Hospital, Ibnsina Teaching Hospital, Omdurman Military Hospital, and Omdurman Teaching Hospital in Khartoum State in the period from March 2020 to February 2021. The study included all patients 18 years and older diagnosed with acute sinusitis. The data was collected by a well-structured questionnaire designed to meet the objectives of the study and analyzed using SPSS 20. Any COVID-19 suspect is excluded from the study. Results The total number of patients was 109; of them, 59 (54.1%) were females and 50 (45.9%) were males, and the female to male ratio was 1.18:1. One hundred seven (98.2%) patients received medical treatment and two patients (1.8%) did take the medications. Eighty-one patients (74.3%) were cured with medical treatment and only 28 patients (25.7%) needed surgical intervention. The age group from 25 to 40 years old was the most affected, accounting for 68 patients (62.4%), and the above 60 years old (3.7%) was the least affected group. Conclusion Acute sinusitis is not an uncommon disease, if addressed properly and timely is medically treatable in most cases apart from complicated cases. This study shows that the active working ages (25-40) were the most affected. Few patients needed surgery (FESS). Negligence could result in complications. Diseases like COVID-19 affect the upper respiratory tract, and there is a similarity in symptoms, and in the advent of the COVID-19 pandemic nowadays, differentiation is of paramount importance.