Ghareeb Nawaz, Muhammad Rafiq Khan.
Primary sinonasal tuberculosis in North-West Pakistan.
J Coll Physicians Surg Pak Jan ;14(4):221-4.

Objective: To record the frequency of primary involvement of nose and paranasal sinuses with tuberculosis in today`s situation in the north-west region of Pakistan. Design: An observational study. Place and Duration of Study: The Department of ENT and Head and Neck Surgery, Khyber Teaching Hospital, Peshawar from 1986 to 1996. Patients and Methods: A total of ten cases of primary sinonasal tuberculosis were included. The inclusion criteria were biopsy and acid-fast bacilli (AFB) examination after Ziel Neelsen (ZN) staining. Patients were put on anti-tuberculous chemotherapy. Response to the therapy and compliance of the patients were studied through follow up. Patients were admitted and offered surgical treatment wherever needed. Results: The primary sinonasal tuberculosis affected mainly young adults (18-60 years), both genders almost equally. Majority (80%) of the patients belonged to far-flung rural areas and all (100%) were poor. More frequent presenting features were granular lesion and mass in the nose (40%), epistaxis (30%), septal perforation (30%), external deformity (30%), palpable cervical lymph nodes (30%) and others. All the cases were diagnosed microscopically. Compliance to treatment was not good. Conclusion: The incidence of primary tuberculosis of nose and paranasal sinuses has risen in the recent past. The patients manifested no evidence of pulmonary tuberculosis.

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