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[Chronic rhinosinusitis with septal perforation. Differential diagnostic considerations]
W Mann1, P Bumb, E Märker-Hermann
1HNO-Klinik und Poliklinik der Johannes-Gutenberg-Universität Mainz, Langenbeckstrasse 1, 55131 Mainz, Deutschland. Mann@hno.klinik.uni-mainz.de
Wegener's granulomatosis can manifest as chronic rhinosinusitis and nasal septal perforation. Early treatment with sulfatrimethoprim and immunosuppressants may prevent systemic disease progression.
Area of Science:
- Otolaryngology
- Rheumatology
- Immunology
Background:
- Chronic rhinosinusitis and nasal septal perforation, especially without prior trauma, suggest Wegener's granulomatosis.
- Diagnostic challenges exist as nasal biopsy and serologic tests are often inconclusive.
Observation:
- Patients present with chronic rhinosinusitis and nasal septal perforation.
- Pain in the nasal skeleton may be present.
Findings:
- Wegener's granulomatosis is a possible diagnosis in these cases.
- Otolaryngologists play a key role in initiating treatment.
Implications:
- Coordinated care between otolaryngologists and rheumatologists is crucial.
- Sulfatrimethoprim and immunosuppressants can stabilize symptoms.
- Prompt intervention may prevent progressive systemic disease.
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