Granulomatous disorders of the nose and paranasal sinuses: perspective from low- and middle-income countries.

Abstract

Purpose of review: This is a comprehensive overview of current trends in the prevalence, clinical presentation, diagnostic challenges and management of granulomatous disorders involving the nose and paranasal sinuses in low- and middle-income countries. Emphasis is placed on infective aetiologies contributing to granulomatous diseases and the emerging innovations in the diagnosis and management of these conditions.

Recent findings: Granulomatous inflammations represent a distinctive spectrum of conditions arising from infectious, autoimmune, neoplastic, and chemical exposures. The prevalence of these disorders varies globally, with infectious aetiologies being more common in subtropical regions and autoimmune inflammatory conditions predominating in Western countries. Notably, the global burden of certain infectious granulomatous diseases is declining due to improved awareness, socio-economic conditions, and enhanced access to healthcare.However, the incidence of invasive fungal mucormycosis has risen sharply following the COVID-19 pandemic, particularly in the Indian subcontinent. Contributing factors include diabetes mellitus, excessive use of high-dose corticosteroids, and environmental influences. Early diagnosis, along with aggressive surgical debridement and antifungal therapy, remains critical for successful management.

Summary: Otolaryngologists must be aware of granulomatous conditions affecting the nose and paranasal sinuses, given their potential to cause significant morbidity if left untreated. Timely diagnosis relies on clinical suspicion supported by blood tests, imaging, and histopathology for effective intervention.