800 A Rare Cause of Unilateral Facial Palsy in an Adult Presenting to a Tertiary ENT Centre

Abstract

Abstract Introduction Sinonasal inverted papilloma are benign tumors usually appearing in 5th decade of life. They are characterised by their recurrent nature with extensive local destruction and malignant potential. Case Report A 54-year-old male was referred to our tertiary centre for further management of recurring Inverted papillomas. On review in clinic, he was found to have right facial palsy- House Brackman (HB) grade V with extensive disease in nasal passages and external auditory canal (EAC) bilaterally. This was associated with reduced visual acuity (VA)- 6/12 and proptosis of the right eye. CT Head was suggestive of a lesion involving the right mastoid, external and middle ear, extending into the right middle cranial fossa is likely to account for the right facial nerve palsy. The MRI scan showed multiple enhancing massess in the nasal cavity, the right mastoid and tympanic cavity, the left tympanic cavity with further possible disease in the oropharynx and nasopharynx. He was admitted to hospital from clinic for surgical management and underwent Endoscopic debulking of nasal tumour + Biopsy of bilateral external auditory canals + biopsy of pharynx. The patient was discharged a day after undergoing the procedure and remained well on ENT follow-up visit. He was further referred to Oncology team once histology results were available which showed Nonkeratinising sinonasal carcinoma and is due to receive his first dose of chemotherapy shortly. Conclusion The study showcases the need for awareness in such conditions and potential complications that can arise due to disease progression.