Presented at the Triological Society Combined Sections Meeting, Miami, Florida, U.S.A., January 25–28, 2012.
Article first published online: 2 JUL 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 9, pages 1893–1897, September 2012
How to Cite
Haffey, T., Woodard, T. and Sindwani, R. (2012), Paranasal sinus exostoses: An unusual complication of topical drug delivery using cold nasal irrigations. The Laryngoscope, 122: 1893–1897. doi: 10.1002/lary.23384
The authors have no funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 23 AUG 2012
- Article first published online: 2 JUL 2012
- Manuscript Accepted: 2 APR 2012
- Manuscript Received: 29 FEB 2012
- Sinus exostoses;
- paranasal sinus exostoses;
- complications of nasal irrigation;
- topical drug delivery;
- cold irrigations;
- Level of Evidence: 4
The use of topical drug delivery through nasal irrigations can minimize systemic side effects and deliver higher concentrations of drugs directly to diseased sinus mucosa. Complications related to this popular method of treatment are not well described. We present our experience with paranasal sinus exostosis (PSE), a new diagnostic entity that appears to be a complication of cold nasal irrigations.
Retrospective chart review.
Retrospective chart reviews were performed on patients within the Cleveland Clinic Foundation from 2005 to 2011. Six patients were identified with sinus exostoses. A literature review for “sinonasal exostoses” and “paranasal sinus exostoses” was performed using PubMed.
Six patients with PSE were identified at the Cleveland Clinic Foundation between 2005 and 2011. All patients had undergone sinus surgery, and none had documented evidence of PSE prior to surgery. There was no evidence of worsening PSE once the cold irrigations were stopped. No patients showed any resolution of PSE over time. None of our patients has progressed to have disease burden significant enough to require intervention.
PSE is a rare condition that mirrors a well-described otologic process; exostoses of the external auditory canal. PSE appears to be a complication of cold nasal irrigations. It does not resolve with the halting of cold irrigations, but does not appear to progress further after intervention. PSE only affects postoperative patients. With the evolving trend to treat postoperative sinus disease topically, the clinician should be aware of the dangers of cold irrigations, and patients should be counseled accordingly.