1. Case presentation

2. Name – Mr. Boranna Age – 40yrs Sex- male Occupation- coolie Add - chalakere

3. Chief complaint Bilateral nasal obstruction – 4 months More on rt side

4. History of presenting illness B/l nasal obstruction -4 months More on rt side Insidious in onset, intermittent, constant Ass with repeated episodes of cold with nasal discharge which is watery in consistency Reduces on medication

5. Past 15 days days nasal obstruction is continuous h/o post nasal drip + h/o reduced sense of smell+ h/o snoring + h/o change of voice +

6. No h/o sneezing No h/o facial pain or headache No h/o tinnitus, ear pain or discharge No h/o foul smell from nose or foul taste No h/o watering of eyes, nose or throat No h/o sneezing No bleeding from nose No h/o trauma to face/nose No h/o dryness of nose

7. Past history Not a known case of DM/hypertension No h/o asthma / drug allergy /TB drug/ bleeding disorder h/o RTA 4 months back with trauma to foot, no trauma to face or head No h/o surgery or hospitalization

8. Family history No h/o similar complaints in family Patient is married and have 2 children

9. Personal history Mixed diet B/B- regular Sleep- undisturbed Appetite- good No habits

10. General examination Patient is conscious, cooperative Moderately built and nourished Pallor- BP- 130/80mmhg Icterus- pulse-80beats/min Clubbing- afebrile Cyanosis- Lymphadenopathy- Edema-

11. Systemic examination CVS- S1S2 heard, no murmur R/S- b/l NVBS+ P/A- soft, no organomegaly CNS- no focal neurological deficit

12. ENT examination Nose- External appearance Root, dorsum, tip, supratip, ala, columella, vestibule- normal

13. Anterior rhinoscopy examination Septum is in midline, no deviation Bilateral pale,polypoidal mass filling the nasal cavity On probing it is insensitive to touch Doesnot bleed on touch Can be probed all around except superolaterally On rt side only a part of inf turbinate can be visualized, lt side turbinate not seen

14. Cold spatula test – no misting seen on rt side PRE – normal PNS- no tenderness

15. Ear – bilateral normal Throat – oral cavity - normal orophaarynx- normal Neck - normal

16. Probable diagnosis Bilateral ethmoidal polyps