Nasal Sarcoidosis Research Articles

涙囊鼻腔吻合術を施行した鼻腔サルコイドーシスの2例

涙囊鼻腔吻合術を施行した鼻腔サルコイドーシスの2例

Sinonasal Sarcoidosis: A Case Report

Sarcoidosis is a chronic granulomatous disease of unknown etiology which principally affects the lower respiratory tract & lungs. Sarcoidosis in the head & neck region is infrequent. Isolated sino nasal sarcoidosis without pulmonary involvement is rare.Case: An 18 years old male patient presented with the complaints of nasal blockage, purulent nasal discharge which was occasionally blood stained for 6 months, deformity of nose, swelling of face & lips for 4 months & watering of eyes for same duration. Endoscopy of nose revealed intra nasal mucosal thickening which was friable & bleeds on touch. The diagnosis of sino nasal sarcoidosis was made by histopathological examination of nasal biopsy specimen.Conclusion: Sino nasal sarcoidosis is a disease of diagnostic challenge to the clinician as its mimicking clinical features may be misleading & cause delay in definitive diagnosis. In the current case report, we presented a case of sino nasal sarcoidosis presenting as chronic rhino sinusitis.Bangladesh Journal of Medical Science Vol.15(4) 2016 p.648-650

Surgical Management of Cutaneous Nasal Sarcoidosis Involving the Alar Rim

Systemic sarcoidosis is a granulomatous disorder that can affect multiple organs and tissues, resulting in varied clinical presentation. Head and neck manifestations are common and are often referred for appropriate diagnoses and management. Nasal cutaneous involvement, although an uncommon presentation, can result in nasal deformities and/or obstruction significantly impairing a patient's quality of life. Currently available pharmacological agents for the management of cutaneous sarcoidosis have yielded inconsistent results and, in the past, have been associated with disease relapse. Traditionally, surgery has largely been avoided because of the theoretical risk of disease flare-up. In the present report, the authors present a patient with atypical nasal cutaneous sarcoidosis involving the alar rim that was successfully managed with surgical intervention.

Nasal sarcoidosis: a cause for a medical rhinoplasty?

We report the use of triamcinolone injections to correct severe nasal deformity due to sarcoidosis, as an alternative to formal surgical rhinoplasty. A 30-year-old woman with a long-standing history of sarcoidosis presented to a tertiary referral rhinology clinic complaining of breathing difficulty and nasal deformity. Flexible nasoendoscopy revealed red nasal plaques typical of nasal sarcoidosis, together with significant widening of the nasal bridge. Triamcinolone, a long-acting corticosteroid, was injected both intralesionally and subcutaneously over the nasal dorsum, at zero, three and eight months, resulting in long-lasting improvement of the nasal shape. Sarcoidosis is a non-caseating, granulomatous, epithelioid inflammation. Otorhinolaryngological manifestations occur in approximately 10 per cent of patients; however, there is little published experience of nasal reconstruction in such patients. We describe a quick, simple and relatively cost-effective technique, with little or no co-morbidity, with which to improve the aesthetic and symptomatic outcomes of nasal sarcoidosis.

Nasal reconstruction in advanced sinunasal sarcoidosis

Sarcoidosis can lead to devastating nasal deformities and impairment of nasal respiratory function. There is only very little published experience with nasal reconstruction in this disease entity. In general, a cautious attitude prevails out of fear of complications or failure due to the underlying granulomatous inflammation. A 57-year-old lady presented to our institution with a 20-year history of sarcoidosis with sinunasal involvement. The findings included a saddle nose deformity, absent nasal septum and conchae, left-sided alar collapse and cutaneous involvement of the nasal tip with discoloration. In a first procedure, we performed a reconstructive nasal surgery with porous polyethylene grafts. In a second procedure, we used a paramedian forehead flap for a partial nasal reconstruction. The functional and asthetic improvement was very satisfactory for the patient during the 2-year follow-up period. This is the first reported use of a forehead flap in nasal sarcoidosis. It demonstrates that major reconstructive nasal surgery and implantation of porous polyethylene grafts can successfully be performed in patients with sinonasal sarcoidosis during remission.

鼻腔サルコイドーシス例

Although sarcoidosis is a systemic disease, the involvement of the nasal cavity is fairly uncommon. We present a 27-year-old female whose final diagnosis was nasal sarcoidosis. Nasal obstruction was the sole symptom at her first presentation. She underwent deviatomy of the nasal septum and submucosal turbinectomy. The pathological findings suggesting sarcoid granulomatosis indicated a whole body examination. No lesion in the lung, eye and skin was found at that time. Because of her deteriorating nasal lesions such as acute frontal sinusitis and recurrence of the nasal obstruction, she underwent another biopsy about a 18 months after the first surgery. The pathological findings suggested sarcoid granulomatosis and a second whole body examination was performed. The presence of skin, eye and chest lesions in the examinations lead to the final diagnosis of sarcoidosis originating from the nasal cavity. Treatment with local steroids decreased her symptoms. A close follow-up was planned due to the chronic and progressive course of the lesions of her nasal cavity.

A Case of Nasal Sarcoidosis Involving Intraturbinate Medulla Complicated With Allergic Rhinitis

Since the first report of nasal sarcoidosis in 1905, several reports have described this condition. In systemic sarcoidosis, the upper respiratory tract may be involved more frequently than generally believed. Many of the reports, however, showed involvement of sarcoidosis only in nasal mucosa. We describe, for the first time, a case of sarcoidosis involving the intraturbinate bone with complete nasal obstruction complicated by typical allergic rhinitis. A 30-year-old Japanese man first visited our hospital in August 1997 with a low-grade fever and neck and inguinal lymph node swelling with tenderness. There were no nasopharyngeal symptoms. Neither pathologic breath sounds nor a heart murmur was heard. No skin eruption was detected. The lymph nodes of the cervical, auxillary, and inguinal regions were palpable. The biopsy of a supraclavicular lymph node revealed a noncaseating granuloma. The patient was diagnosed with sarcoidosis. http://www.entnet.org/journal/casereports/OTO-06.pdf/

鼻腔サルコイドーシスの２例

Sarcoidosis is a systemic disease of unknown cause. Most cases involve the lungs, lymph nodes, skin, and eyes. However, sarcoidosis with nasal symptoms is less frequent. We present two cases of nasal sarcoidosis with nasal obstruction. One patient was a 29-year-old female with nasal obstruction, skin lesions, neck lymph node swelling, and BHL. The other patient was a 31-year-old female who was diag-nosed with sarcoidosis with skin lesions and BHL in 1994. She presented to our hospital with complaints of nasal obstruction. Both patients' pathological findings for the nasal mucosa were granulomatous structure without necrosis, and were diagnosed with nasal sarcoidosis. The first patient was treated with local steroids and the nasal symptoms nearly disappeared completely. The other patient was treated with surgical management and local steroids, and the nasal symptoms were controlled.

The nasal manifestations of sarcoidosis: a review and report of eight cases

We report eight patients presenting to the Department of Otorhinolaryngology between 1990 and 1998 in whom a diagnosis of sarcoidosis was made. The most common presenting symptom was that of nasal obstruction and crusting and the most common site of involvement was the septum and inferior turbinate. These patients differ from the majority of patients who present with the other manifestations of sarcoidosis in that they are older. Where mucosal changes are present within the nose, biopsy gives a high diagnostic yield. The aim of treatment is to gain symptomatic control with the lowest dose of steroids. The majority of patient's nasal symptoms were managed with local measures and topical steroids. Nasal disease tends to follow a prolonged but benign course. Few had other organ involvement. While nasal sarcoidosis remains a rare cause of nasal obstruction, biopsy of abnormal nasal mucosa along with further investigations as dictated by history, examination and histological findings is important if delay in diagnosis is to be avoided.

Sarcoidosis Presenting as Nasal Obstruction

Sarcoidosis is a chronic systemic granulomatous disease of unknown etiology. The histology of this disease was first reported by Boeck in 1899. Since that time many reports of multiple organ involvement have been published. Symptoms relating to the upper respiratory tract are not uncommon. Nasal obstruction as the presenting and primary complaint in sarcoidosis however is a rare but important symptom as it may lead to the diagnosis of this treatable disease. We present three patients whose initial complaint of progressive nasal obstruction heralded the diagnosis of sarcoidosis upon further workup. The clinical presentation, diagnostic workup, histology, and management of nasal sarcoidosis are discussed.

Nasal sarcoidosis : A cosmetic problem

The literature relating to nasal sarcoidosis is reviewed and a case report about a patient with a gross nasal deformity due to sarcoidosis is presented.

Sarcoidosis in ENT practice.

Thirteen cases of sarcoidosis were seen at the Royal National Throat, Nose and Ear Hospital and St George's Hospital, Tooting, between 1963 and 1984 inclusive. In only 5 patients had a diagnosis of sarcoidosis been made prior to attendance. In the remaining 8 patients, there was a considerable delay in making a diagnosis in those cases with predominantly nasal symptoms, ranging from 8 to 18 months. Several patients with nasal sarcoidosis had evidence of systemic disease on investigation, but did not receive appropriate treatment early in the course of their disease because of the delay in initial diagnosis. Both the ENT surgeon and the general practitioner must be aware that symptoms of nasal obstruction, rhinorrhea and crusting are not always due to an allergic or vasomotor rhinitis, and granulomatous conditions should always be considered in the differential diagnosis of patients with these symptoms.

Cutaneous nasal sarcoidosis—treatment by excision and split-skin grafting

We report two cases of nasal sarcoidosis which are both treated by excision and split-skin graft and yield good results after one year and three years' follow-up.

Sarcoidosis of the nose and paranasal sinuses.

Sarcoidosis is a chronic systemic disease of unknown etiology characterized by non-caseating granulomatous inflammation of various organs. The records of 2319 patients with the diagnosis of sarcoidosis were reviewed to determine the incidence of nasal involvement. Seventeen patients or approximately 1% of the patients with sarcoidosis had histologically proven nasal mucosa involvement. These patients had symptoms of nasal crusting, congestion, epistaxis, pain, or anosmia. The clinical findings in these patients included friable nasal mucosa, nasal polyps, or a characteristic submucosal nodularity. Most patients also had abnormal sinus roentgenograms with either thickening of the sinus mucosa or opacification of the sinuses. Biopsy of the nasal mucosa shows typical non-caseating granulomas, but care must be exercised to exclude other causes of granulomatous inflammation of the nasal mucosa including tuberculosis, fungal infections, and other idiopathic granulomatous diseases such as Wegener's granulomatosis and Churg-Strauss syndrome. The treatment of nasal sarcoidosis has consisted of systemic steroids and in some cases topical beclomethasone dipropionate.