Chronic Rhinosinusitis with Left Nasal polyp in an Adult Male with Occupational Dust Exposure and Allergic Rhinitis: A Case Report.

Abstract

Background:

Nasal polyps are benign inflammatory lesions arising from the mucosa of the nasal cavity and paranasal sinuses. Although the diagnosis is usually straightforward on anterior rhinoscopy and nasal endoscopy, the pathogenesis is incompletely understood, recurrence rates are high, and treatment outcomes are variable. Nasal polyps associated with chronic inflammatory nasal disease are managed with corticosteroids, allergen control, and surgery when conservative measures fail.

Case Presentation:

A 44-year-old man presented with left-sided nasal obstruction for one month that had become continuous over the preceding several days, accompanied by difficulty breathing and a foreign-body sensation in the nose. He had a prolonged history of rhinitis with symptoms triggered by dust and cold air. On anterior rhinoscopy, both nasal cavities were narrow with pale, hypertrophic inferior turbinates. A pale, shiny, smooth, mobile, pedunculated, non-tender mass was visible in the left middle meatus, occupying it without completely obstructing the nasal cavity. Nasal endoscopy confirmed the finding. The working diagnosis was a left nasal polyp with associated allergic rhinitis. Differential diagnoses included antrochoanal polyp and nasal tumor. Management included nasal saline irrigation, education on allergen avoidance, systemic and intranasal corticosteroids, an oral antihistamine, and referral to an otorhinolaryngologist for further evaluation and consideration of endoscopic polypectomy.

Conclusion:

Nasal polyps should be suspected in patients presenting with progressive nasal obstruction and a background of allergic rhinitis or chronic irritant exposure. Anterior rhinoscopy combined with nasal endoscopy can support the diagnosis and characterize the extent of the lesion. Medical therapy forms the cornerstone of initial management, with surgical referral indicated when the polyp causes significant obstruction or does not respond adequately to medical management.