General Medical Information

Granulomatous Sinusitis

Barbara A. Zeifer

Granulomatous disease affecting the nose and paranasal sinuses can be infectious or noninfectious. Infectious diseases include actinomycosis, nocardiosis, blastomycosis, tuberculosis, syphilis, rhinoscleroma, and leprosy. Noninfectious entities include Wegener granulomatosis, sarcoidosis, and foreign-body reaction from beryllium, chromate salts, and cocaine. All the granulomatous diseases are potentially destructive and can erode both cartilage and bone. These entities have similar radiographic features. Initially, nonspecific soft-tissue nodules are found along the nasal septum with marked mucosal thickening and retained secretions. Perforation of the cartilaginous nasal septum is the hallmark of this group of disorders. Destruction of the bony septum and sinus walls occurs later as the disease progresses.