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Clinical Problem Solving
August 2013

Nasal Congestion, Postnasal Drip, and Aural Fullness

Author Affiliations
  • 1Washington University School of Medicine, St Louis, Missouri
  • 2Hospital of the University of Pennsylvania, Philadelphia
JAMA Otolaryngol Head Neck Surg. 2013;139(8):849-850. doi:10.1001/jamaoto.2013.3843

A 54-year-old man presented with a 3-month history of worsening right-sided nasal congestion, postnasal drip, and aural fullness. He denied epistaxis but complained of headaches and facial pain over his right frontal and maxillary sinuses. He had completed 2 courses of erythromycin, a course of methylprednisolone, and a trial of albuterol, all with partial relief. He reported a history of allergic rhinitis and recurrent sinusitis with aural fullness but denied smoking or environmental exposures. There was no external nasal deformity. Rigid nasal endoscopy revealed a pale, multilobulated mass high in the right nasal cavity and medial to the middle turbinate (Figure, A). The lesion obstructed the middle meatus by mass effect and lateralization of the middle turbinate with secondary obstruction of the maxillary ostium and frontal recess. The nasal septum was midline without disease in the left nasal cavity.

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