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Clinical Problem Solving
February 2014

Nasal Dyspnea and Intermittent Epistaxis

Author Affiliations
  • 1Naval Medical Center, Portsmouth, Virginia

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Otolaryngol Head Neck Surg. 2014;140(2):179-180. doi:10.1001/jamaoto.2013.5981

A preteen boy presented to an allergist with a 1-year history of nasal dyspnea and intermittent epistaxis. The nasal dyspnea, initially on the right side, slowly progressed to complete, bilateral nasal obstruction. He was diagnosed as having environmental allergies and treated medically without improvement. He was referred to the pediatric otolaryngology clinic for treatment of a right nasal mass.

Anterior rhinoscopy revealed a white to gray-colored polypoid lesion in the right nare. It was firm and rubbery to palpation. The lesion deviated the nasal septum significantly to the left nasal sidewall and occluded both sides of the nasal cavity.