A 4 year-old malay girl presented to ENT clinic with history of unilateral foul smelly yellowish discharge with blood stained and nasal blockage of left nose for the past 6 months. initially associated with fever on and off. denied any foreign body or trauma prior to that. Otherwise no noisy breathing, no sorethroat, no ear problem.
On examination revealed comfortable child, afebrile. anterior rhinoscopic examination showed mass at left nostril. cold spatula test noted obstructed airway at left nostril. throat and ear examnation were unremarkable. then proceed with flexible nasopharygolaryngoscope (FNPLS), mass with pooling of mucus at left inferior and middle meatus of left nostril. Fossa of Rosenmueller (FOR) clear. No cervical lymphadenopathy.
Child posted for Examination under anaesthesia (EUA) KIV removal of rhinolith under general anesthesis (GA). Intraoperatively, showed gel-like material occupying inferior meatus up to middle meatus of left nostril. no rhinolith seen. nose toilet performed. granulaion tissue of inferior turbinate biopsied sent for histopathological examination (HPE).
differential diagnosis of this child most probably is infected foreign body or rhinolith left nose. Other differential diagnosis is nasal polyps, everted papilloma.
Child may be discharged in 1-2 days after operation. Then she will be prescribed with antibiotic and analgesic. In 1-2 weeks time, nose should be reexamined and to review HPE result.
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