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Clinical Problem Solving: Radiology
August 2005

Radiology Quiz Case 4

Author Affiliations
 

R. NICKBRYANMDPATRICIA A.HUDGINSMD

Arch Otolaryngol Head Neck Surg. 2005;131(8):741. doi:10.1001/archotol.131.8.741

A 54-year-old woman from Ethiopia presented with a several-year history of headache, nasal airway obstruction, and uncomfortable nasal breathing. She had immigrated to Israel 5 years earlier. Her medical history included asthma and reflux esophagitis due to a hiatal hernia.

Physical examination revealed foul-smelling crusts in both nasal passages. After removal of the crusts, no intranasal structures, such as conchas, could be identified. Fiberoptic endoscopy confirmed the findings of anterior rhinoscopy: no conchas were identified and only rudimentary small mucosal outgrowths were seen. The nasal passages were enlarged and wide open to the nasopharynx.

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