1. Bakhshaee M, MD Mordad 1389 Patient of The Month

2. 23 year-old man with nasal obstruction

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

4. 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

5. 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

6. Endoscopic View

7. Imaging

8. Diagnosis Benign vs Malignant Lesion

9. Differential Diagnosis

10. Fungal Ball

11. Management Endoscopic vs Conventional Surgery