A clinical study on unilateral proptosis : the ever expanding ent spectrum

Background: Proptosis is a sign in search for a diagnosis. Though a common manifestation of orbital pathology it could be an early and at times only manifestation in patients with nasal and paranasal sinus pathology. This makes the role of an Otorhinolaryngologist important with endoscopes having revolutionized the management of these patients. Method: The clinical study was conducted at the Department of ENT, Government Medical College Kozhikode over a period of one year using convenience sampling. All patients with unilateral proptosis satisfying the inclusion criteria were completely evaluated with history and clinical examination followed by relevant investigations including imaging to reach the diagnosis. Results: In our study 38% patients had malignancies of nose and paranasal sinuses and 62% benign, inflammatory lesions. This sign was common in patients in the 5th & 6th decade of life and more in men irrespective of the etiology. Nasal obstruction was the predominant symptom. Imaging helped in evaluating the extent of the lesion and planning the approach in surgery. Conclusion: Proptosis is a sign that requires a multidisciplinary approach for appropriate diagnosis and treatment. It is necessary to be able to diagnose neoplastic lesions of nasal and paranasal sinuses from other inflammatory and benign lesions. Nasal endoscopy with biopsy is the gold standard in diagnosis.