Chronic Rhinosinusitis with Nasal Polyps in an Adolescent with a History of Allergies and Asthma.

Abstract

Background

Chronic rhinosinusitis with nasal polyps (CRS-NP) is an inflammatory condition of the nasal mucosa and paranasal sinuses that persists for more than 12 weeks. It is relatively uncommon in children and adolescents but is frequently associated with allergic diseases and asthma. Diagnosis is based on persistent symptoms and objective findings on nasal endoscopy and imaging. This case report describes CRS-NP in an adolescent patient with allergic and asthmatic risk factors who required functional endoscopic sinus surgery (FESS) and polypectomy.

Case Report

A L A 14-year-old girl presented with left-sided nasal congestion for 3 months, worsening over the preceding 2 weeks. Symptoms were associated with hyposmia, rhinorrhoea, pain, intermittent headache, snoring and itchy watery eyes. She had a history of asthma as well as allergy to dust and cold air. Anterior rhinoscopy revealed a narrow left nasal cavity and a solitary greyish-white mass in the left middle meatus. Nasoendoscopy confirmed a polypoid mass in the left middle meatus. Computed tomography demonstrated left maxillary sinusitis with hypertrophy of the left nasal conchae and obliteration of the left Osteomeatal complex. Based on the clinical, endoscopic, and radiological findings, a diagnosis of CRS-NP was established. The patient received antihistamines, systemic corticosteroids and intranasal corticosteroids followed by FESS and polypectomy. Postoperative evaluations showed marked improvement in nasal patency, complete relief of obstruction and no evidence of early recurrence.

Conclusion

CRS-NP needs to be considered in adolescents presenting with persistent nasal obstruction, hyposmia and a history of allergic disease or asthma. Endoscopy and CT imaging facilitate accurate and timely diagnosis. Management consists of combined medical therapy and FESS with polypectomy. Regular follow-up remains essential to detect recurrence.