Intended for healthcare professionals

Endgames Spot Diagnosis

Chronic unilateral nasal congestion

BMJ 2018; 363 doi: (Published 24 October 2018) Cite this as: BMJ 2018;363:k3971
  1. Zhenxiao Huang, consultant otolaryngologist,
  2. Jingying Ma, consultant otolaryngologist,
  3. Bing Zhou, consultant rhinologist
  1. Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
  1. Correspondence to B Zhou entzhou{at}

An 18 year old man was referred to the otolaryngology (head and neck surgery) department with persistent right sided nasal congestion for one year. He had used a nasal corticosteroid spray in the six months before presentation, but his symptoms had not improved.

At the otolaryngology department he underwent a non-contrast computed tomography scan of his sinuses (fig 1). What is the diagnosis?

Fig 1

Computed tomography scans of the sinuses (coronal planes)


Antrochoanal polyps (ACPs) in the right sinonasal cavity (fig 2).

Fig 2

Computed …

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