Clinical Characteristics, Diagnostic Features, and Medical Treatment of Sinonasal Sarcoidosis: A Systematic Review.
Cali Loblundo, Priyanka Shah, Shaun A Nguyen et al.
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In 30 seconds
This systematic review examined clinical presentation, diagnosis, and medical treatment of sinonasal sarcoidosis (SNS), drawing on 68 case reports, case series, and observational studies involving 369 patients. Mean age was 39.6 years, and 66.5% were female. The average interval from symptom onset to diagnosis was 61.7 months (95% CI: 35.8-87.6). Nasal obstruction, rhinorrhea, and crusting were common presentations; sinonasal mucosal biopsy most often confirmed the diagnosis. Systemic corticosteroids were the predominant first-line treatment, with 77.0% of patients showing clinical improvement, although prolonged courses and relapses were common.
Key findings
- The average delay from symptom onset to SNS diagnosis was 61.7 months (95% CI: 35.8-87.6).
- Presenting symptoms included nasal obstruction (39.3%), rhinorrhea (29.1%), and crusting (26.4%).
- Sinonasal mucosal biopsy provided histological confirmation in 75.4% of patients.
- With systemic corticosteroids, 77.0% of patients demonstrated clinical improvement; prolonged treatment and relapses were common.
Why it matters
SNS can resemble common inflammatory nasal conditions, and the review found a substantial interval between symptom onset and diagnosis. Recognising the reported symptom and endoscopic patterns, alongside frequent extra-nasal manifestations, may help clinicians consider SNS and pursue diagnostic evaluation. The treatment findings also indicate that improvement with corticosteroids does not necessarily mean a short or relapse-free course.
What to keep in mind
The evidence comprised case reports, case series, and observational studies, rather than randomised trials; treatment outcomes and estimates therefore reflect heterogeneous non-randomised evidence.