AAO-HNSF Primary Care Otolaryngology Handbook

CHAPTER 8

Patients with chronic rhinosinusitis may have deviated septum, turbinate hypertrophy, nasal polyps, or other anatomical variations that predispose them to obstruction of the sinus ostia. A common area of blockage is the osteomeatal complex , where the frontal, ethmoid, and maxillary sinuses drain into the middle meatus. Patients who have an obstruction in this area and have clinical chronic rhinosinusitis or recurrent acute bacterial sinusitis, who have failed medical therapy, may benefit from surgery to widen this area by removing the uncinate process and ethmoid bulla and widening the natural ostia of the maxillary sinus or dilating the osteome- atal complex with a balloon. These procedures are performed through the nose endoscopically. Nasal Masses By far the most common nasal masses encountered by physicians are nasal polyps. Other types of intranasal masses include inflammatory etiologies, such as pyogenic granuloma, Wegner’s granulomatosis, and sarcoidosis. Neoplasms, including inverting papilloma, juvenile nasopha- ryngeal angiofibroma, esthesioneuroblastoma, sinonasal undifferentiated carcinoma, adenocarcinoma, and other malignancies, are fortunately not as common.

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Primary Care Otolaryngology