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A 50-year-old male with a history of chronic sinusitis with nasal polyposis (CRSwNP) presents with increased left retro-orbital pressure and headaches for the past several months. He states that he has the triad of nasal polyposis, asthma, and aspirin…

photo credit: Pablo Rogat/Shutterstock.


Please use the discussion feature below to ask the authors your questions and provide further feedback on others’ questions. All questions and replies are moderated.


  1. Artur Gevorgyan

    1. Did you consider doing an MRI to r/o a chance of encephalocele or meningioencephalocele? The CT appearance is not consistent with it, but given a large area of skull base dehiscence, I believe an MRI would be useful.

    2. Given significant dehiscence and carotid exposure, why not consider doing this in the OR, in the safest setting?

  2. Paula tardim lopes

    the patient had enlargement of the nasal pyramid due to the polyposis desease?

    Have he already used long term antibiotics macrolideo Class?


    1. William Yao


      The patient did not have any enlargement of the nasal pyramid. The image of the patient above is a representative image, not related to this case.

      He has tried oral macrolide and multiple other topical antibiotic irrigation per his former rhinologists. His current issue was the expansile mucocele in the left sphenoid sinus.

      I hope this clarifies your question.


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