A Case Report on Wegener’s Granulomatosis Presenting as Refractory Chronic Rhinosinusitis in a Saudi Patient

This chapter discuss about Wegener’s Granulomatosis in A Saudi Patient Presenting as Refractory Chronic Rhinosinusitis Following Septoplasty and FESS. Wegener’s Granulomatosis, now known as Granulomatosis with polyangiitis is a potentially lethal systemic disorder that is characterized by necrotizing vasculitis of small arteries and veins. The respiratory system is most commonly affected in limited forms of the disease, however upper and lower respiratory system, systemic vasculitis, and necrotizing glomerulonephritis are the characteristic components of the disease triad. A 45 year old Saudi man presented to the outpatient ENT clinic of NWAFH with complaints of diffuse headache, nasal obstruction and blood-stained rhinorrhea for the last 3-4 weeks after septoplasty and FESS elsewhere. He then experienced lung and renal issues before being identified as having Wegener's granulomatosis. He was started on the usual course of treatment, which produced remission. The disease responds well to cytotoxic agents and corticosteroids and the prognosis has improved with these agents. In certain cases of chronic nasal blockade and crusting not responding to usual measures then this disease should be considered.