Paranasal Sinus CT Research Articles

Impact of bilateral nasal polyposis on the interoptic and interzygomatic distance.

To identify and determine variations on eye distance in patients with bilateral nasal polyposis (BNP) compared to a healthy control group. This is a case-control study that included 20 BNP patients and 40 healthy controls. We included all patients with BNP confirmed by pathology and a computed tomography scan. A healthy control group was admitted, filtered by the exclusion criteria of nasal polyposis, craniofacial malformations, and encephalocele. Paranasal sinus CT scans were performed in all participants, and two measures were evaluated, the interoptic (soft tissue) and the interzygomatic (bone structure) distances. A total of 20 BNP subjects, 13 (65%) male and 7 (35%) female, with a mean age of 38.8years, and 40 healthy controls, 16 (40%) male and 24 (60%) female with a mean age of 43.2years, were included. The mean interoptic distance was 69.7mm (71.9mm men, 66.4mm women) and interzygomatic distance was 103.1mm (104.5mm men, 100.6mm women). A significant increase of the interoptic (p < 0.001) and interzygomatic (p < 0.002) measurements was found in patients with polyposis compared to the controls. In the receptor operative curve analysis, the interoptic distance had an area under a curve of 96% and the threshold that maximizes the sensitivity and specificity was 59.85mm (sensitivity 90%, specificity 95%, PPV 90%, NPV 95%). An increase in ocular and orbital distances was identified in patients with BNP. Polyposis may be identified by measuring eye separation. The established cut point distance identifies patients that may benefit from follow-up. Further research in this study line is suggested.

Paranasal Sinus CT Is of Variable Value in Patients with Pediatric Cancer with Neutropenic Fever

When patients with pediatric cancer are found to have a fever without a source, CT of the paranasal sinuses, chest, abdomen, and pelvis has often been used as a screening tool. I question the role of sinus CT in this protocol. It is commonly understood among radiologists that most children have

Radiological study of the myriad variations in frontal sinus anatomy: an institutional study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; The frontal sinus is a challenging area for endoscopic surgeons. The variations in the frontal sinus differs so much among individuals that there are forensic applications. A detailed radiological study of the sinus is important for understanding the pathophysiology of sinusitis and as a prerequisite for frontal sinus drainage procedures. Aims and objectives were to document the anatomical variations of the frontal sinus (radiological) and to correlate the variations with the signs and symptoms of sinusitis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; Coronal and axial CT paranasal sinuses scans of 30 consecutive patients who attended the Otolaryngology clinic OPD in St. John’s medical college and hospital, Bangalore, India with signs/symptoms of chronic sinusitis were evaluated between January to July 2018. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The average frontal sinus diameter in patients with sinusitis was 6.65 mm. The prevalence of frontal cells in our study was 48%. Agger nasi cells were the most common cells seen. Frontal sinus disease was found in 72% of the studied sides in the scans.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Frontal sinus anatomy varies with different ethnicities. It is very important to study the frontal sinus anatomy before exploring the sinus for disease clearance and avoid surgical complications.&lt;/p&gt;

The effect of frontal sinus pneumatization on anatomic variants of paranasal sinuses.

The aim of this study is to determine the effect of frontal sinus pneumatization on various variations of paranasal sinuses on maxillofacial CT. A total number of 120 patients (62 females, 58 males) were included in this study. Patients were divided into three groups regarding their frontal sinus pneumatization extent on paranasal sinus CT as Type 1 pneumatization (aplasia and hypoplasia), Type 2 pneumatization (medium) and Type 3 pneumatization (hyperplasia). The prevalence of various variations on paranasal sinus CT like pneumatization of upper and middle concha, presence of agger nasi, Haller and Onodi cell, maxillary sinus and sphenoid sinus hypoplasia, pneumatization of anterior clinoid process, pterygoid process and greater wing of sphenoid sinus, dehiscence and protrusion of internal carotid artery and optic nerve and vidian canal types were ascertained and compared within each group. The prevalence of upper and middle concha pneumatization, Haller cell, pneumatization of anterior clinoid process, pterygoid process and greater wing of sphenoid and internal carotid artery dehiscence and protrusion was higher in Type 3 group compared with other groups. Excessive pneumatization of frontal sinus has various effects on paranasal sinus variations at maxillofacial CT. Surgeons dealing with endoscopic sinus surgery, maxillofacial and skull base surgery must be vigilant of association between certain variations when analyzing CT scan preoperatively for avoiding complications.

Significance of Nasal Septum Angulation and Its Association with Rhinosinusitis Symptom Scores

Objective:The aim of the study was to determine the association of angulation of nasal septum with the severity of rhinosinusitis as measured by symptom score and Visual Analog Score (VAS).Method:The study was performed as a cross sectional study conducted at two different centres in Malaysia. Ninety-eight patients who were diagnosed with rhinosinusitis and fulfilled the selection criteria were assessed as for the symptom score and VAS and the measurement of angulation of nasal septum was performed through a coronal view of CT paranasal sinuses in bone window setting at osteomeatal complex level.Results:The result obtained from one-way ANOVA test revealed a significant association between category of severity of septal angulation and the symptom score of rhinosinusitis (p=0.025). In addition, the result obtained from one-way ANOVA test also revealed a significant association between category of severity of septal angulation and the VAS of rhinosinusitis (p<0.05).Conclusion:Severity of nasal septum angulation may be significantly associated with severity of rhinosinusitis based on symptom score and VAS. These findings could be used in tailored management of patient with rhinosinusitis especially during functional endoscopic sinus surgery.

Is Performing the Paranasal Sinus CT Before the Septal Operation Change the Indication of Surgery?

Is Performing the Paranasal Sinus CT Before the Septal Operation Change the Indication of Surgery?

Bilateral subdural empyemas with meningitis secondary to acute barosinusitis

IntroductionIntracranial complications of acute rhinosinusitis are rare, but may turn life-threatening. Case summaryWe report a healthy 30-year-old male who complained of frontal headache, which developed while on a plane. A brain CT showed a low-density lesion on the left frontal convexity with right maxillary and ethmoid sinusitis. Despite receiving intravenous antibiotics, a follow-up brain CT showed two lesions with adjacent dural and leptomeningeal enhancement. A paranasal sinus CT revealed aggravated left frontal sinusitis and right maxillary sinusitis. The patient underwent craniotomy and brain abscess removal along with endoscopic sinus surgery. Seventeen days after the surgery, the patient was discharged with no neurological sequelae. ConclusionTo the best of our knowledge, this case is the first report regarding the association between barotrauma and intracranial complications of acute rhinosinusitis. A high index of suspicion and well-timed surgical evacuation may ensure a full recovery.

A study on image quality and radiation dose reduction effect through Virtual Non Contrast method for paranasal sinus CT

A study on image quality and radiation dose reduction effect through Virtual Non Contrast method for paranasal sinus CT

Leontiasis ossea; a rare presentation of secondary hyperparathyroidism

Leontiasis ossea is a rare presentation of renal osteodystrophy with few reports in literature. It causes severe skeletal deformity in the cranial bones. This study presents a report on a patient with advanced hyperparathyroidism with skeletal changes compatible with leontiasis ossea. The patient was a 34-year-old man with end-stage renal disease, uncontrolled hypertension, and dyspnea who was referred to our hospital. Physical examinations revealed: toggled speech (nasal speech), mouth breathing and facial change, saddle nose, nares widening, increased interdental space and mandibular enlargement. His serum intact parathyroid hormone (iPTH) level was 3199 pg/mL, Paranasal sinuses CT scan showed a significant expansion of the mandibular, maxillary and skull bones. Parathyroid sonography reported two severe hypertrophied parathyroid glands. The patient underwent total parathyroidectomy as a result of symptomatic bone involvement.

Comparison of the therapeutic effect of the Persian Medicine Protocol with the common treatment of chronic rhinosinusitis: a randomized clinical trial.

BackgroundChronic rhinosinusitis is one of the most common diseases affecting the quality of life of patients. Patients suffer from high costs in the diagnosis and treatment of the disease. Frequent recurrence and failure of therapeutic protocols are among the most important issues in the management of this disease. In view of this, the use of traditional and complementary therapies to promote the treatment of this disease has been increasingly taken into account.ObjectiveComparison of the effectiveness of the Persian Medicine Protocol with the conventional therapy in the treatment of chronic rhinosinusitis.MethodsA randomized clinical trial was conducted at Imam Reza Hospital in Mashhad, Iran from July 2016 to March 2017. For patients with chronic rhinosinusitis symptoms, endoscopy of the sinuses was performed by an ENT specialist and in the case of negative endoscopy, paranasal sinus CT scan was requested. A total of 42 patients with chronic rhinosinusitis were randomly assigned to two groups. The first group (classical) received systemic and intranasal cortisone, and the second group (traditional) received a therapeutic Persian medicine protocol including intranasal lavender oil, and Liquorice Marjoram Tea (L. M. tea) for six weeks. The symptoms of the patients were evaluated using the SNOT-22 questionnaire at the beginning of the study and at the sixth week. If no improvement occurs, treatment continued for 12 weeks. Data were analyzed by SPSS version 16, using ANOVA, independent-samples and paired-samples t-test, Wilcoxon signed-rank test, and simple linear regression.ResultsIn 20 patients in the traditional group, the decrease in SNOT score was observed as 56% after 6 weeks treatment (p=0.001), which is similar to the effect of the first group (classical). Although there was no statically significant difference between the two groups, in clinical terms, the difference in mean systemic symptoms such as confusion with 1.05 (p=0.5) and fatigue with 1.63 (p=0.01) had more improvement in the traditional group, and the difference in mean local symptoms such as nasal congestion with 2.37 (p=0.78) and runny nose with 1.95 (p=0.14) had a more decrease in the classical group.ConclusionThe results of this trial indicate the effectiveness of the Persian Medicine Protocol (including Lavender oil and L.M tea) in the treatment of chronic rhinosinusitis, especially on improving systemic symptoms. Nevertheless more clinical studies are necessary to support the acquired results.Trial registrationThis trial was registered at the Iranian Center for Clinical Trials (ID: IRCT2015112425217N1).FundingThis research is part of a PhD thesis and is funded by the Vice-Chancellor for Research at Mashhad University of Medical Sciences, Grant No. 931673.

Clinical efficacy and safety of Biyuan Tongqiao granule combined with triamcinolone acetonide nasal spray in the treatment of chronic rhinosinusitis

Objective To observe the clinical efficacy and safety of Biyuan Tongqiao granule combined with triamcinolone acetonide spray in the treatment of patients with chronic rhinosinusitis. Methods A total of 106 patients with chronic rhinosinusitis in the Traditional Chinese Medicine Hospital of Anji County from February 2015 to February 2017 were selected as study objects.According to different treatment plan, the patients were randomly divided into the control group and the combined group, with 53 cases in each group.The control group received triamcinolone acetonide nasal spray 220μg, 1 time/d, one week later, the dosage adjusted to 110μg, 1 time/d.The combined group was given Biyuan Tongqiao granules 15 g, three times /d on the basis of the treatment of the control group.The clinical efficacy, SONT-20, VAS score, paranasal sinus CT score and incidence rate of adverse reaction were analyzed before and after treatment in the two groups. Results The total effective rate of the combined group was 94.34%, which was higher than 81.13% of the control group, the difference was statistically significant (χ2=4.296, P=0.038). The SNOT-20, VAS and Lund-Mackey sinus CT score in the combined group were better than those in the control group, the differences were statistically significant (t=7.661, 9.189, 7.183, 9.269, 10.470, all P<0.05). The incidence rate of adverse reactions in the two groups was 7.55%, the difference was not statistically significant (χ2=0.000, P=1.000). Conclusion Biyuan Tongqiao granule combined with triamcinolone acetonide spray in the treatment of patients with chronic rhinosinusitis can improve the clinical efficacy and reduce pain of patients, it is worthy of popularization and promotion in clinical. Key words: Rhinitis; Sinusitis; Chronic disease; Biyuan tongqiao granule; Triamcinolone acetonide spray; Comparative effectiveness research

Chronic respiratory rhinitis

The clinical distinction of chronic respiratory rhinitis appears to confirm the evo-devo theory of the three noses. The authors report two cases of advanced allergic rhinitis, in which chronic inflammation had induced a violaceous colour of the mucosa of the respiratory nose and a whitish polypoid appearance of the free edge of the middle turbinate. Nose and paranasal sinus CT scan revealed, beyond the virtual nasal cavities observed on nasal endoscopy and CT imaging, normal radiolucency or only minor opacities of the ethmoid (i.e. olfactory nose) and paranasal sinuses that could not explain the severity of the chronic nasal dysfunction. The hypothesis of non-allergic chronic respiratory rhinitis is developed according to these two observations. The differential diagnosis between chronic respiratory rhinitis and dysfunction of the cavernous plexuses of the respiratory nose is discussed. A precise diagnosis appears to be a prerequisite for appropriate and effective management. Surgery of the respiratory nose can associate septoplasty to inferior turbinoplasty, but must be preceded and combined with medical treatment adapted to the underlying inflammatory process.

Eosinophilic granulomatous polyangiitis with lung involvement: clinical analysis of 8 cases

Clinical data, imaging finding, laboratory and pathology results of 8 patients with eosinophilic granulomatous polyangiitis (EGPA) admitted in our hospital from April 2014 to September 2016 were retrospectively analyzed. There were 7 cases with sinus involvement; 8 cases with increased eosinophil counts in peripheral blood, bronchoalveolar lavage fluid (BALF) and induced sputum, and with negative antineutrophil cytoplasmic antibodies (ANCA). Lung function tests showed mild obstructive ventilation dysfunction in 7 cases, positive relaxation test or excitation test in 4 cases, and mild dispersion function decline in 4 cases. Chest CT revealed multiple ground glass shadows and peripheral pulmonary nodules in both lungs in 4 cases, and bronchial wall thickening in 1 case. Transbrochial lung biopsy (TBLB) indicated extravascular infiltration of acidophilic granulocytes. Four cases were treated by glucocorticoid monotherapy, the other 4 cases were treated by glucocorticoids combined with cyclophosphamide. All patients achieved clinical relief after treatment, but 3 cases recurred. For suspicious EGPA patients in addition to paranasal sinus CT, ANCA vasculitis index, urine routine and renal function tests, it is necessary to perform nasal mucosa, bronchial mucosa, transbrochial lung biopsy and BLAF, induced sputum cytology to obtain timely diagnosis and treatment. Key words: Churg-Strauss syndrome; Bronchial alveolar lavage fluid

Transsphenoidal surgery in Cushing disease: The challenging microadenoma (Local experience)

Abstract Background: Cushing disease is uncommon challenging disease. The adenomas are usually small in size in most case making the disease diagnosis and management is sometimes difficult. In some cases, the tumor cannot be identified on imaging studies and in many cases the adenoma is eccentric in location adding more difficulties to the trans-sphenoid approach for excision of such tricky tumors. Object: to evaluate the challenge of diagnosis and trans-sphenoid surgery for ACTH pituitary microadenomas. Methods: 21 patients with ACTH secreting adenomas were involved in this retrospective study. All cases were operated up on via trans-sphenoid approach during the period from January 2009 till October 2015. All of them were microadenomas. All patients had obvious Cushing manifestations. In all cases magnetic resonance (MR) imaging and CT paranasal sinuses were performed. In this study: cases with macroadenomas and recurrent cases after previous trans-sphenoid approach or gamma knife radiosurgery were excluded. Results: Among the 21 patients; 14 were female and 7 weremale with age ranging from 21 to 44 years. The imaging study was positive for microadenoma in 18 patients while in 3 cases; no tumor was seen on the MRI imaging. All were operated via the trans-sphenoid approach (12 patients via the microscopic technique and other 9 patients via the endoscopic technique). The adenoma was successfully removed in 15 out of the 18 patients with evident adenoma on pre-operative MRI imaging while partial hypophysectomy were done in 5 cases without an evident adenoma on pre-operative MRI study or difficult adenoma identification. In one patient; the procedure was aborted because of sphenoid sinus abnormalities and the tumor was successfully removed via trans-cranial approach. Disease remission was achieved in 17 patients. In 4 patients; complete remission was not achieved and gamma knife radiosurgery was done after surgery. Disease progression occurred in two patients with initial remission and was treated gamma knife radiosurgery. 13 patients had an ACTH deficiency after surgery while other hormonal replacement therapy is needed in only 5 cases. CSF rhinorrhea occurred in 2 patients and was managed with transient lumbar drain without any subsequent morbidities. Transient diabetes insipidus occurred in 6 cases and was treated conservatively. Conclusions: The transsphenoidal approach ACTH secreting pituitary microadenomas is considered safe and effective for achieving disease remission despite the challenge of diagnosis and intra-operative tumor identification.

Imaging and anatomical features of ethmomaxillary sinus and its differentiation from surrounding air cells.

The aim of this study was to investigate the imaging anatomical characteristics and clinical significance of the ethmomaxillary sinus (EMS). The study included a total of 280 ENT Outpatient Department patients with nasal symptoms whose paranasal sinus CT scans were analyzed from January 2012 to December 2016. The anatomical imaging characteristics of EMS were observed. EMS was observed in 23 of 280 patients, with an incidence of 8.2%. Bilateral EMS appearance in 17 cases (73.9%) was significantly higher than that of unilateral EMS in 6 cases (26.1%) (P < 0.01). EMS occurs when there are anterior or anterior-inferior cells of the posterior ethmoidal sinus (PEs) extending toward the maxillary sinus (MS) and entering the MS through the maxillary hiatus rather than spreading from outside of the MS. EMS is surrounded by five walls, and the main position of EMS was invariably located in the posterior-superior corner of the MS and draining to the superior nasal meatus (SNM). EMS must be differentiated from SNM, sphenoid sinus, and retromaxillary pneumatization of PEs, because they may appear between the MS and the orbital floor. EMS was not a rare variation that should be careful identification during endoscopic sinus surgery. Accurately confirming EMS is the key to completely opening and removing lesions in the MS and EMS.

CT observation of retromaxillary posterior ethmoid

Objective:To investigate the morphologic characteristics of the retromaxillary posterior ethmoid.Method:A total of 103 outpatients encountered in our hospital during March 2012 and December 2012,who completed paranasal sinus CT examination,were included in this study.Patients had no sinus trauma,surgery or tumor history.Their paranasal sinus CT scans were analyzed from scheduled axial and coronal plane.The incidence and imaging features of the retromaxillary posterior ethmoid were observed.Result:The retromaxillary posterior ethmoid(RMPE)was the posterior ethmoid cell that expanded along the lamina papyracea toward the infraorbital region.RMPE was located behind the posterior wall of the maxillary sinus and under the orbital floor.The occurrence rate of the RMPE was 74.3%.The ethmomaxillary septum is the bony septum the between the maxillary sinus and posterior ethmoid.Anatomical confirmation of RMPE is based mainly on the presence of the ethmomaxillary septum.RMPE is located at the back of ethmomaxillary septum.The sagittal angulation of the ethmomaxillary septum ranged from 22 to 87 degrees,with an average of(50.34±12.10)degrees.Conclusion:The ethmomaxillary septum is important for anatomic recognition of the RMPE.Accurate identification of the RMPE before ESS can help improve the removal of the posterior ethmoid sinus.

High-pitch dual-source paranasal sinus CT in agitated patients with maxillofacial trauma: analysis of image quality, motion artifacts, and dose aspects.

Background Image quality benefits from high-pitch scanning in agitated patients by reducing acquisition time. Purpose To compare image quality and exposure parameters in patients with maxillofacial trauma on second- and third-generation dual-source computed tomography (DSCT). Material and Methods Four groups were compared. Group 1 was examined on second-generation DSCT (120 kV/50 mAs, pitch 3.0). The other three groups were examined on third-generation DSCT. Group 2 was scanned with 120 kV/50 mAs, pitch 2.2. Automated exposure control (AEC) was used in group 3 and group 4 with pitch factors of 2.2 and 3.0, respectively. Images of third-generation DSCT were reconstructed with iterative reconstruction (IR), of second-generation DSCT with filtered back-projection. CTDIvol, acquisition time, and image quality were compared. Results Thirty patients were included in each group. Average CTDIvol (2.76 ± 0.00 mGy, 2.66 ± 0.00 mGy, 0.74 ± 0.23 mGy, and 0.75 ± 0.17 mGy) was significantly lower on third-generation DSCT with AEC ( P < 0.001). Subjective image quality was rated worst in group 4 due to strong high-pitch artifacts, while in the remaining three groups it was rated good or very good with good inter-observer agreement (k > 0.64). Average acquisition time was significantly shorter with third-generation DSCT (0.47 s, 0.36 s, 0.38 s, 0.30 s; P < 0.001). Conclusion Third-generation DSCT yields faster acquisition times and substantial dose reduction with AEC. A pitch of 2.2 should be preferred, as it results in fewer artifacts. If AEC is used, latest IR ensures that diagnostic image quality is guaranteed.

The Pneumatization and Adjacent Structure of the Posterior Superior Maxillary Sinus and Its Effect on Nasal Cavity Morphology.

BackgroundThe aim of this study was to observe the pneumatization degree and adjacent structure of the posterior superior maxillary sinus (PSMS) and its effect on nasal cavity morphology.Material/MethodsThe study included a total of 103 cases whose paranasal sinus CT scans had been analyzed. The pneumatization of the PSMS and its relationship with posterior ethmoid sinus (PEs) and sphenoid sinus (SS) were observed. The effects of the pneumatization of PSMS on nasal cavity width and morphology also were evaluated.Results1) The PSMS was adjacent to orbit or middle nasal meatus (MNM) as type I in 5.82% of cases. The PSMS was adjacent to the orbit and superior nasal meatus (SNM) as follows: the superior part of medial wall of maxillary sinus (MMS) was not abutting on PEs as type II (4.35%) and abutting on PEs as type III (85.9%). If the type III was not accompanied by MMS shift toward medial it was identified as type IIIa (33.50%), and if it was accompanied MMS shift toward medial, it was identified as type IIIb (45.63%). The ethmomaxillary sinus (EMS) was identified as type IIIc (6.80%). The PSMS directly abutted on the SS as type IV in (3.88%). 2) The higher the degree of the pneumatization of PSMS was, the narrower the width of the upper part of the posterior nasal cavity (p<0.05 respectively).ConclusionsThe relationship of PSMS with the orbit, SNM, PEs, and SS should be identified pre-operation; it is important for safety and complete removal of retromaxillary lesions during endoscopic sinus surgery. The pneumatization degree of PSMS also should be considered as it can influence the morphology of posterior nasal cavity.

Lower Airway Inflammation in Eosinophilic Chronic Rhinosinusitis as Determined by Exhaled Nitric Oxide

Background: Chronic rhinosinusitis (CRS) is classified into eosinophilic CRS (ECRS) and non-ECRS. The objectives of this study were to evaluate lower airway inflammation by measuring the fractional concentration of exhaled nitric oxide (FeNO) and to examine the effects of endoscopic sinus surgery (ESS) on FeNO in patients with ECRS compared to non-ECRS. Methods: CRS patients with nasal polyps (23 with ECRS and 22 with non-ECRS) were enrolled into this study. ECRS was diagnosed based on the definition proposed by the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) study group. Several clinical markers including blood eosinophil counts, percent of eosinophils in white blood cells (WBC), number of eosinophils in nasal polyps, JESREC scores, total IgE, FeNO, and Lund-Mackay paranasal sinus CT scores were compared between ECRS and non-ECRS. These markers were also tested before and 2 months after ESS. Results: FeNO was significantly higher in patients with ECRS than in non-ECRS patients. When all CRS patients were tested, a significant correlation was found between FeNO and eosinophilic markers including blood eosinophil counts, percent of eosinophils in WBC, number of eosinophils in nasal polyps, and JESREC scores. FeNO showed a significant correlation with Lund-Mackay scores only in ECRS patients. Blood eosinophil counts, percent of eosinophils in WBC, and FeNO decreased after ESS only in ECRS patients. Conclusions: ECRS patients had lower airway inflammation as revealed by an elevated FeNO, which was parallel to the Lund-Mackay CT scores. ESS decreased the blood eosinophils and FeNO, leading to an improvement of the occult pulmonary dysfunction in ECRS patients.

Proboscis Lateralis with Rhinosinusitis

Objective: This report aims to describe unique manifestations of proboscis lateralis and highlight the importance of a multidisciplinary approach to address the problems that arise from this rare congenital anomaly.&#x0D; Methods: &#x0D; Study Design: Case Report&#x0D; Setting: Tertiary Government Hospital&#x0D; Patient: One&#x0D; Results: A 13 year-old girl diagnosed with proboscis lateralis presented with a trunk-like appendage projecting from the surface of the right supramedial canthal area. She also had clear nasal discharge, nasal congestion, mouth-breathing, and snoring since birth. Paranasal Sinus (PNS) CT scan with 3D reconstruction showed agenesis of the right paranasal sinuses, and expansile aeration of the left paranasal sinuses. Due to her condition, the drainage system of the paranasal sinuses was obstructed, causing chronic rhinosinusitis (CRS). This hindered plans for reconstructive surgery despite medical management, hence the patient underwent Endoscopic Sinus Surgery (ESS).&#x0D; Conclusion: Proboscis lateralis is a rare congenital anomaly that results in aesthetic problems as well as airway concerns, such as rhinosinusitis and obstructive sleep apnea syndrome (OSAS). Management entails a multidisciplinary approach to address functional and aesthetic problems of the patient.&#x0D; Keywords: proboscis lateralis, chronic rhinosinusitis, obstructive sleep apnea, endoscopic sinus surgery, multidisciplinary approach, plastic surgery, reconstructive surgery