Sarcoidosis Presenting as Chronic Sinusitis with Facial Fistulization

Abstract

Sarcoidosis is a multisystem granulomatous disorder of unknown etiology most commonly affecting young adults and frequently presenting with bilateral hilar lymphadenopathy, pulmonary infiltration, and skin or eye lesions. Usually there is involvement of more than one organ system with clinical and radiographic findings supported by histological evidence of widespread noncaseating, epitheloid cell granulomas. The clinical course varies from a self-limited mild problem to a fulminant progressive widespread granulomatous inflammatory process producing severe fibrosis. An unusual case of sarcoidosis that presented with chronic sinusitis with fistulization onto the nasal dorsum and stenosis of the nasal vestibules is reported. The literature concerning the subject is reviewed. Long-term treatment for many years may be required to prevent clinical relapse.