Woake's Syndrome Abscessed in Adults: Case Report

Abstract

Introduction: We present the case of a 71-year-old male patient with a history of aspirin intolerance, bilateral nasal polyposis. He consulted for sudden onset swelling of the right nasal pyramid of less than 24 hours of evolution to assess drainage. Physical examination revealed a soft tumor on the right lamina of the right nasal bone and bilateral Lindholdt grade II nasal polyposis with no other findings.. A computed tomography (CT) of the paranasal sinuses with contrast was requested, showing a bony defect in both proper bones and an abscess at the level of the nasal dorsum. The abscess was drained and antibiotic therapy woth intravenous corticosteroid treatment was started.

Discussion: Woakes' syndrome is defined as severe and recurrent nasal polyposis with erosion and enlargement of the nasal pyramid.The etiology is unknown. Some authors have suggested hereditary factors and in many cases it is not possible to identify an etiological factor. It usually occurs in children and young adults due to the plasticity of growing facial bones and very rarely in adults. Cases associated with frontal sinus hypoplasia or bronchiectasis have been described in children.In recent years a decrease in the number of cases of Woakes syndrome has been described, probably due to earlier diagnosis and the improvement in the different treatments for nasal polyposis, whether medical or surgical. We have not found any case of abscessed Woakes syndrome described in the recent literature.

Conclusion: Woakes sd. Woakes is a rare clinical form of chronic nasosinusal polyposis of unknown etiology. Management is the usual management of nasosinusal polyposis, based on topical or oral corticosteroids often complemented with endoscopic nasosinusal surgery that can improve quality of life and stabilize the disease.

Keywords: Bilateral nasal polyposis; Rhinology; Sinus surgery; Woakes’ syndrome.