Woakes Syndrome: A Case Report

Introduction: Woakes syndrome is characterized by presence of polypoid mass occupying ethmoid complex, extending the bone pyramid, leading many authors called it deforming ethmoiditis or frog face. Later, this definition was expanded adding aplasia of the frontal sinus, bronchiectasis, and discrinia. The diagnosis is made by physical examination, observing polypoid masses, which may be restricted to the middle and top floor of the nasal cavities or occupy them entirely. Treatment is with topical and systemic corticosteroids and surgical procedures are reserved for cases of failure of clinical treatment and extensas polyposis.

Objective: This study aims to report case of Woakes syndrome treated at Hospital Regional de Presidente Prudente, SP, Brazil, in May 2013.

Resumed Report: A 75-year-old male patient (A. C.), sought the Otorhinolaryngology service, complaining of nasal obstruction for 17 years, accompanied by purulent rhinorrhea and mouth breathing without pretreatment. Rhinoscopy displays polypoid lesions and enlargement of nasal pyramid. Tomography: Content soft tissue filling the maxillary, frontal, ethmoid, and sphenoid sinuses bilaterally obliterated osteomeatal complex and nasal cavity with grease until posterior nasopharynx. Fibronasolaryngoscopy presents polypoid lesion in the right middle meatus, not exceeding inferior turbinate, as well as yellowish discharge in the middle meatus. Degloving was performed without complications. Currently, we use budesonide nasal 100 µg/d with no signs of recurrence.

Conclusion: Woakes syndrome is a rare disease whose polyps cause nasal deformity and recur frequently. Therefore, surgery should be extended in order to restore nasal function and avoid recurrence.