Proptosis in ENT Department: Presentation and Management

Abstract

Objective: The main aim of this study was to manage proptosis caused by different nasal and paranasal sinus diseases. Study Design: This was a retrospective descriptive study. Settings: The study was carried out in department of otorhinolaryngology and Head & Neck surgery, Allied Hospital, Faisalabad Medical University, Faisalabad. Duration: Two years i.e; June 2014 to May 2016. Methodology: 30 patients with proptosis because of some nasal and paranasal sinus disease. Data Analysis: To analyze data SPSS software version 10 and Chi square test were employed. Results: 56.6% were males and 43.4% were females among a total of 30 patients. The age of these patients was ranging from 06 to 67 years with mean age of 34.3 years. In this study 70% patients had unilateral proptosis and 30% patients with bilateral proptosis. 53.3% patients had nasal polyposis causing proptosis; 23.3% unilateral and 30% being bilateral nasal polyposis. 90% of our patients were found to have nasal obstruction; unilateral nasal obstruction in 60% whereas bilateral in 30%. Nasal mass was seen in 23.3% and epistaxis was observed in 30% of the patients. 13.3% of our patients had facial swelling and 53.3% had tele canthus. 50% of the patients were found to have fungal disease either in the nose or paranasal sinuses causing proptosis. Among these 18 patients having proptosis due to fungal disease, 10 patients (55.5%) were immunocompetent. On the other hand, the remaining 08 patients (44.5%) were immunocompromised and metabolically moribund. Smokers were 16.6%, diabetes mellitus was seen in another 16.6% and 13.3% of the patients had hypertension. Different surgical procedures were used to treat the lesions responsible for unilateral or bilateral proptosis. The basic aim of the treatment was to clear the disease completely and orbital repositioning. Conclusion: Although endoscopic sinus surgery is considered the treatment of choice at present in experienced hands yet midfacial degloving approach is another excellent surgical option to treat majority of these sino-nasal diseases causing proptosis especially at those settings where FESS like modern facility is not available