Our Summary

This research paper talks about a woman in her 70s who went to a primary care clinic with sudden dizziness. She was initially diagnosed with vestibular neuritis, an inflammation of the inner ear, and treated with steroids. However, her symptoms got worse, and she went to the emergency department the next day. A brain scan didn’t reveal any issues, but a CT scan without contrast dye showed a soft tissue growth in her posterior ethmoid sinus, a small hollow space behind the nose. Her dizziness completely disappeared before a specialist in ear, nose, and throat (ENT) disorders surgically removed the nasal growth. This growth actually started from the right cribriform plate, a thin bone between the brain and the nasal cavity, and extended to the front middle turbinate head, a structure inside the nose. The final diagnosis was a seromucinous hamartoma, a rare benign growth consisting of mucus-producing cells and other tissues.

FAQs

  1. What was the initial diagnosis of the woman who presented with acute onset dizziness?
  2. How was the nasal polyp detected in the patient?
  3. What was the final pathology of the nasal mass removed from the patient?

Doctor’s Tip

One helpful tip a doctor might tell a patient about nasal polyp removal is to follow post-operative care instructions carefully to prevent complications and promote healing. This may include avoiding strenuous activities, keeping the nasal passages moist with saline spray, and taking prescribed medications as directed. It is also important to attend follow-up appointments with your healthcare provider to monitor your recovery progress.

Suitable For

Patients who are typically recommended nasal polyp removal are those who have:

  • Persistent symptoms such as nasal congestion, runny nose, postnasal drip, and decreased sense of smell despite medical treatment.
  • Recurrent sinus infections or chronic sinusitis that do not respond to antibiotics.
  • Severe nasal polyps that obstruct the nasal passages and cause difficulty breathing.
  • Nasal polyps that are causing other complications such as obstructive sleep apnea or recurrent sinus infections.
  • Nasal polyps that are associated with other conditions such as asthma or cystic fibrosis.

Timeline

Before nasal polyp removal:

  • Patient presents to primary care clinic with acute onset dizziness
  • Initially diagnosed as vestibular neuritis and treated with steroids
  • Presents to emergency department with worsening symptoms
  • Imaging reveals soft-tissue mass in posterior ethmoid sinus
  • Vertigo completely resolves before surgery

After nasal polyp removal:

  • Otolaryngologist surgically removes nasal mass
  • Mass is found to originate from right cribriform plate and extend to anterior middle turbinate head
  • Final pathology confirms seromucinous hamartoma

What to Ask Your Doctor

  1. What are the risks and benefits of nasal polyp removal surgery?
  2. What is the success rate of nasal polyp removal surgery in terms of symptom improvement?
  3. What is the recovery process like after nasal polyp removal surgery?
  4. Are there any alternative treatments or therapies for nasal polyps that I should consider before opting for surgery?
  5. How long will I need to be off work or limit my activities after nasal polyp removal surgery?
  6. Are there any potential complications or side effects associated with nasal polyp removal surgery that I should be aware of?
  7. Will I need to follow up with you or another healthcare provider after the surgery, and if so, how often?
  8. Can you explain the pathology results of the nasal mass that was removed and what it means for my overall health?
  9. Is there anything I can do to prevent nasal polyps from recurring in the future?
  10. Are there any lifestyle changes or modifications I should make to improve my nasal health post-surgery?

Reference

Authors: Raviprasad AG, Malaty J, Wynne B, Orlando FA. Journal: BMJ Case Rep. 2023 Nov 1;16(11):e254889. doi: 10.1136/bcr-2023-254889. PMID: 37914165