Sinonasal manifestations of sarcoidosis: a single institution experience with 38 cases

Abstract

Sinonasal involvement was noted in approximately 30% of patients with known sarcoidosis evaluated in the otolaryngology clinic. Patients typically present with nasal obstruction and endoscopic evidence of crusting and mucosal thickening. Medical therapy with irrigations and topical/oral steroids suffices in majority of patients, with surgery for refractory symptoms being required in a small subset of cases.

An unusual case of nasal sarcoidosis

“…Findings may mimic other diseases, a n dt h i s ,c o u p l e dt ot h ef a c tt h a tu pt o8 0%o f patients with subcutaneous sarcoid have no signs of systemic sarcoidosis [4], makes clinical diagnosis challenging. The few case reports in the literature show a preponderance for middle-aged women [5].…”

“…On suspicion of sarcoid, patients should undergo a thorough full body clinical examination. Manifestations of sarcoid in the nose [5] include red intra-nasal plaques, obstruction, crusting and epistaxis as well as cartilage destruction with resultant widening of the nasal bridge and saddle nose deformity. Consideration should be given for early pulmonological/rheumatological consult.…”

Sinonasal Involvement in Sarcoidosis: Case Report

“…1,6,7,[11][12][13][14][15] Sarkoidozun nazal tutulumunun kesin teşhisi için nazal biyopsi gerekir. Histolojik tanıda nonkazeifiye granülomların görülmesi ve enfeksiyöz/nonenfeksiyöz granülomatöz hastalıkların ekarte edilmesi esastır.…”

“…Lokal ya da sistemik kortikosteroid tedaviye yanıt, tam remisyon ya da yanıtsızlık arasında değişiklik gös-terebilmektedir. 1,7,9,11-13, 15 Kirsten ve ark., immün-supresif tedavi ve tekrarlayan sinüs cerrahilerine rağmen sinonazal hastalığın relapslarla seyrettiğin-den bahsetmişlerdir. 7 Olgumuz burun sağ nazal kanatta ve hemen onun etrafındaki yanak derisinde kırmızı, mavimor renkli şişlik ve burun sırtında çökme nedeni ile başvurmuş, MRG'de "nazal septum anterior ve sağ nazal sırt seviyesinde kemik yapıda ekspansiyona neden olan iki adet yer kaplayıcı lezyon, etmoid hücrelerde havalanma kaybı oluşturan mukozal kalınlaşma'' saptanması üzerine nazal biyopsi ile sinonazal sarkoidoz tanısı almıştır.…”

Editorial

“…The clinical papers in this issue touch on a breadth of sinonasal disease, such as rheumatologic disease, vascular tumors, and new methods to improve surgical outcomes. Clinical sinonasal manifestations of sarcoidosis are describe by Aloulah et al The authors present 38 sarcoidosis patients in a retrospective analysis. Of those with known sarcoidosis, 30% had sinonasal involvement, and the interval between first sinonasal symptoms until diagnosis varied from 2 months to 31 years.…”