Young patient with headache, epiphora, bilateral nasal obstruction, no fever. Diagnosis?
**Core Concept**
The patient's symptoms suggest a nasal mass or obstruction, which can be caused by various conditions such as a nasal polyp, tumors, or other growths. The key to diagnosing this condition is to identify the underlying cause of the nasal obstruction and its impact on the surrounding structures.
**Why the Correct Answer is Right**
The patient's symptoms of headache, epiphora (excessive tearing), and bilateral nasal obstruction are classic signs of a nasal mass or tumor. The presence of a nasal mass can lead to obstruction of the nasal passages, causing symptoms such as difficulty breathing through the nose, nasal discharge, and facial pain. The epiphora is due to the obstruction of the nasolacrimal duct, which leads to the accumulation of tears in the eye. In this case, the most likely diagnosis is a nasal polyp, which is a non-cancerous growth that can occur in the nasal passages.
**Why Each Wrong Option is Incorrect**
* **Option A:** This option is incorrect because it does not account for the patient's symptoms of epiphora and bilateral nasal obstruction. While a deviated septum can cause nasal obstruction, it would not typically cause epiphora.
* **Option B:** This option is incorrect because it does not consider the possibility of a nasal mass or tumor as the underlying cause of the patient's symptoms. While allergies can cause nasal congestion and discharge, they would not typically cause epiphora or bilateral nasal obstruction.
* **Option D:** This option is incorrect because it is too vague and does not provide a specific diagnosis. While sinusitis can cause nasal congestion and discharge, it would not typically cause epiphora or bilateral nasal obstruction.
**Clinical Pearl / High-Yield Fact**
It is essential to consider the possibility of a nasal mass or tumor in patients presenting with symptoms of nasal obstruction, epiphora, and facial pain. A thorough physical examination and imaging studies such as CT scans or MRI can help diagnose and manage these conditions.
**Correct Answer: C. Nasal polyp. Nasal polyp.**