Case for the Month

Welcome to the Otolaryngology Case of the month. Every month an interesting case will occupy this space. It will be selected because of any unusual features at presentation, or management, or because of an important or a rare and intriguing diagnosis. Any comments are welcome on this subject and can be sent by E mail to the address given at the bottom of this page. Whenever possible a case with some grey areas will be selected for discussion to stimulate a lively discussion.Every month a new case will replace the old one.

(As this is a personal web page of the author, there is no affiliation to the institute where the author works or the patient was managed)

Case for this month

March 2001

History A 57 year old man had been treated for a right sided nasal block and discharge for sometime with a diagnosis of chronic sinusitis. As the x ray showed a persistent opacity of the antrum it was decided to do a antral washout. He was better for a short time but soon had the same symptoms again.

Examination The nose was congested but no evidence of any growths or obvious infection.

Investigations Repeat X ray showed a similar opacity of the right maxillary sinus.

Operation In view of these findings  it was decided to explore the sinus via an antrostomy and nasal endoscopy.

Findings The antrostomy did not show any significant pathology in the sinus and the endoscopy did not reveal any abnormality except for a thicken sinus mucosa

Post op Scenario A few hours after the operation when the patient was back to normal he had felt a sensation of something in the back of his throat. On bringing it out what he saw amazed him.

WHAT DID HE BRING OUT ? IF YOU WISH TO KNOW CLICK HERE

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