A 39-year-old woman has been bothered by headache, facial pressure, nasal obstruction with discharge, and diminished taste sensation for the past 6 months. On physical examination there is discomfort on palpation over her left maxillary sinus. No oral lesions are noted. Rhinoscopy shows nasal erythema, marked edema, and purulent discharge. Which of the following complications is most likely to occur in this patient?
Correct Answer: Osteomyelitis
Description: Chronic sinusitis is a common condition and may be punctuated by episodes of acute sinusitis. Lack of smell with nasal cavity inflammation often affects sensation of taste. Once the cycle of inflammation, obstruction, stasis, mucociliary damage, and polymicrobial infection is established it becomes difficult to stop. Increased pressure with inflammation in the sinus can erode into adjacent bone, causing osteomyelitis. A mucocele filled with non-purulent secretions is more likely to occur in frontal and ethmoid sinuses. Sinusitis is not a risk factor for malignancy. Nasopharyngeal carcinomas are related to Epstein-Barr virus (EBV) infection. T-cell lymphomas typically occur in men and are EBV positive. Papillomas most often occur in men and have an exophytic growth pattern, but those that are endophytic aggressively extend into adjacent soft tissue and bone, making removal difficult.
Category:
Pathology
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