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Endgames Case Review

Chronic unilateral nasal obstruction

BMJ 2021; 374 doi: (Published 29 September 2021) Cite this as: BMJ 2021;374:n2194
  1. Qingwu Wu, otolaryngologist,
  2. Qintai Yang, consultant
  1. Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
  1. Correspondence to: Q Yang yangqint{at}

A woman in her early 20s presented to the otorhinolaryngology clinic with a 10 month history of progressively worsening left sided nasal obstruction (“stuffy nose”) and rhinorrhoea. No seasonal pattern was detected. The patient’s right nostril was free of symptoms. She reported no bloodstained nasal discharge, headache, or olfactory dysfunction.

Anterior rhinoscopy showed a pale and translucent polypoid mass, without macroscopic surface ulceration, in the left nasal cavity. Computed tomography of the sinuses (fig 1) showed a dumbbell-shaped polyp with extension in the left sinonasal cavity.

Fig 1

(A) Computed tomography (CT) coronal segment showing a polyp arising from the left maxillary sinus and extending through a widened maxillary sinus ostium into the nasal cavity. …

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