Aspects of the Sinonasal Sarcoidosis Manifestations in Iran

Abstract

Introduction: Sinonasal Sarcoidosis (SNS) is the most common involvement of upper respiratory tract sarcoidosis disease. Not much data is available on the detailed diagnostic aspects of Iranian sinonasal sarcoidosis patients. Aim: The current study is the first report from Iran that evaluates the prevalence and describes the clinical features of patients with sinonasal sarcoidosis in Iran. Materials and Methods: This cross-sectional descriptive study was performed on the eighty eight newly diagnosed and biopsy proven sarcoidosis patients who were suspected to have head and neck disorders. Sinonasal involvement of sarcoidosis was examined via Computed Tomography of Para-nasal Sinuses (CT PNS) imaging as well as rhinoscopy, and histopathologic examinations on the nasal or sinusitis mucosa biopsy sample. Data were analysed by Statistical Package for Social Sciences (SPSS) and differences between two groups were obtained using the χ2 test, the Mann-Whitney test and independent t-test with consideration of a statistically significant p-value of <0.05. Results: Sinonasal disorders were observed in 32 patients. Association of sinonasal and pulmonary sarcoidosis were confirmed in 18 of 32 SNS patients (56.25%). Rhinoscopy investigations demonstrated that the prevalent presenting signs were nasal crusting in 4 patients (14.3%), septal perforation in 3 patients (8.6%), mucosal hypertrophy in 9 patients (28.6%), synechia in 2 patients (5.7%), middle turbinate hypertrophy in 4 patients (11.4%) and submucosal nodule in 10 patients (31.4%). Conclusion: Endoscopic investigations indicated that the most frequent manifestation of SNS cases was inflammatory rhinosinusitis often with nodular lesions on the septum and turbinates. Further studies with bigger sample size are recommended in order to measure the sensitivity and specificity of nasal obstruction as a diagnostic parameter of sinonasal sarcoidosis patients of Iran.

Keywords

• erythema nodosum
• granuloma
• methotrexate
• pulmonary
• sinusitis