Clinical Rhinology

Register      Login

VOLUME 12 , ISSUE 2-3 ( May-December, 2019 ) > List of Articles

Original Article

Myriad of Otorhinolaryngology Diseases Presenting as Unilateral Proptosis

Parijat Joshi, Murundi Basavarajaiah Bharathi, Ambale Rudrappa Babu

Citation Information : Joshi P, Bharathi MB, Babu AR. Myriad of Otorhinolaryngology Diseases Presenting as Unilateral Proptosis. Clin Rhinol An Int J 2019; 12 (2-3):57-62.

DOI: 10.5005/jp-journals-10013-1367

License: CC BY-NC 4.0

Published Online: 01-06-2021

Copyright Statement:  Copyright © 2019; The Author(s).


Aim and objective: To describe the evaluation and management of multiple cases of unilateral proptosis due to various sinonasal pathologies. Materials and methods: Patients presenting to ENT OPD with unilateral proptosis were evaluated, diagnosed, and treated in this prospective study done over 2 years. All cases underwent complete otorhinolaryngological and ophthalmic examination apart from the endoscopic and radiological examination. Proptosis was measured by Hertel's exophthalmometry and readings above 21 mm or a difference of more than 3 mm between the two eyes were taken as positive. The cases were managed with appropriate surgery along with required medical management. Results: Twelve cases were observed over 2 years. The mean age of patients was 48.08 ± 13.02 years. Male:female ratio was 5:1. The most common cause was maxillary carcinoma with an orbital extension (four cases). Surgery was a mainstay of treatment in all patients, along with required medical treatment. Conclusion: A good work up and with surgical management resulted in good recovery of the patients with only one mortality. Sinonasal infections accounted for 25% of cases, benign neoplasms and tumor-like conditions 33%, and the rest 42% were constituted by malignant conditions. Clinical significance: Assessment of proptosis in otorhinolaryngology is of paramount importance as it can be an early and/or only manifestation of nasal or paranasal sinus pathology. Although the incidence of proptosis in everyday ENT practice is exceedingly low, the knowledge of the important causes helps in clinching the correct diagnosis and timely management.

  1. Keche P, Nitnaware AZ, Mair M, et al. A study of tumours giving rise to unilateral proptosis. Indian J Otolaryngol Head Neck Surg 2013;65(Suppl 1):6–13. DOI: 10.1007/s12070-011-0353-0.
  2. Rajenderkumar D. A study on etio-pathology of proptosis in otorhinolaryngology. Indian J Otolaryngol Head Neck Surg 1999;51(4):1–5. DOI: 10.1007/BF03022705.
  3. Rosen FS, Ryan MW. (2004) Surgery for exophthalmos. Grand round presentation UTMB, Department of Otolaryngology. http:/
  4. Venugopal M, Sagesh M. Proptosis: rhe ENT surgeon's perspective. Indian Journal of Otolaryngology and Head & Neck Surgery 2013;65(Suppl 2):247–250. DOI: 10.1007/s12070-011-0367-7.
  5. Sinha V, Bhardwaj D, George A, et al. Proptosis through eyes of E.N.T. Surgeon. Indian J Otolaryngol Head Neck Surg 2005;57(3):207–209. DOI: 10.1007/BF03008015.
  6. Kimmelman CP, Korovin GS. Management of paranasal sinus neoplasm invading the orbit. Otolaryngologic Clinics of North America 1988;21(1):77–92.
  7. Calcaterra TC, Hepler RS, Hanafee WN. Unilateral exophthalmos. Laryngoscope 1974;2(2):231–242. DOI: 10.1288/00005537-197402000-00004.
  8. Wright. Annals of royal college of surgeons. England 1970;47:323.
  9. Frazell BL, Lewis JS. Cancer of nose and paranasal sinusesCancer 1963;16:1293–1313.
  10. Zaidi SH. Unilateral proptosis in ENT practices. J Pak Med Assoc (JPMA) 1991;41(10):248–250.
  11. Johnson LN, Krohel GB, Yeon EB. Sinus tumours invading the orbit. Opthalmology 1984;91(3):208–217. DOI: 10.1016/S0161-6420(84)34300-7.
  12. Popovic D, Milisavljevic D. Malignant tumours of the maxillary sinus—a ten years experience. Med Biol 2004;11(1):31–34.
  13. Bhansali A, Bhadada S, Sharma A, et al. Presentation and outcome of rhino-orbital-cerebral Mucormycosis in patients with diabetes. Postgrad Med J 2004;80(949):670–674. DOI: 10.1136/pgmj.2003.016030.
  14. Yeo G-S, Kim HY, Kwak E-J, et al. Cavernous sinus thrombosis caused by a dental infection: a case report. J Korean Assoc Oral Maxillofac Surg 2014;40(4):195–198. DOI: 10.5125/jkaoms.2014.40.4.195.
  15. Karaman E, Isildak H, Haciyev Y, et al. Carotid-cavernous fistula after functional endoscopic sinus surgery. J Craniofac Surg 2009;20(2):556–558. DOI: 10.1097/SCS.0b013e31819ba1e8.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.