Bakhshaee M, MD Mordad 1389 Patient of The Month

23 year-old man with nasal obstruction

History Six months Gradually progress First left side and recently extent to the right side No Trauma No Allergy No systemic disease No epistaxis

Sign & Symptoms PositiveNegative Bilateral obstruction Hyposmia Mild rhinorrhea Pressure sensation in the nose Fullness in left ear Pain Epistaxis Visual Impairment Fever Toothache Halitosis Trismus Epiphorea Hearing Loss

Physical Exam PositiveNegative Left nasal mass Right septal deviation PND Mild Proptosis Mild left tympanic retraction Neck mass Eye movement restriction Facial deformity Cranial nerve impairment Trismus Visual Loss

Endoscopic View

Imaging

Diagnosis Benign vs Malignant Lesion

Differential Diagnosis

Fungal Ball

Management Endoscopic vs Conventional Surgery