Background: Tornwaldt cyst (TC) is a relatively rare but benign disease. Although these lesions are asymptomatic and found incidentally during routine ENT examination, the can present with unexplained sinonasal symptoms, such as nasal obstruction, post nasal drip and occipital headache. Aim: To study the clinical presentations and outcome of Tornwaldt nasopharyngeal cyst cases diagnosed and managed in our center. Methods: Patients with symptomatic TC who were operated and followed up at our center were selected for this study. Results: 3 patients with a diagnosis of TC by naso-endoscopy, CT and MRI were included in this study. All patients were males, with age ranging from 54 to 86 years. A trans-nasal endoscopic surgical removal of the cyst was done for all patients with no intra or post-operative complications. All patients were free of symptoms and disease reassurance at follow up. Conclusion: Although relatively rare, TC should be suspected in any patient complaining of unexplained sinonasal symptoms. Endoscopic surgical excision is a safe and effective maneuver with no cyst recurrence. Highlights:

Introduction: Intranasal teeth are a rare form of ectopic teeth. Their clinical manifestation are truly variable. In children, intranasal teeth are typically associated with cleft lip and alveolus. Presentation of case: Here, we report a case of 11 years -old girl presented with right nasal obstruction and occasional headache without any obvious etiology. 0Computed tomography of the paranasal sinuses (coronal and axial view) revealed displaced right upper maxillary tooth with the crown oriented inferiorly and medially toward and within the lower right anterior nasal cavity. She underwent surgery by anterior rhinoscopy and endoscopic guidance. The patient's symptoms were resolved completely post-operatively and remained symptom-free for 18 months postoperatively. Discussion: Ectopic intranasal tooth is a rare phenomenon, with a male predominance and around half of all patients are diagnosed before adulthood. Ectopic intranasal tooth arising from inferior turbinate is very rare. No clear etiological factor has been suggested in most of the reported cases. Idiopathic etiology has been described as an etiologic factor for ectopic teeth. The treatment of intranasal teeth is early surgical extraction to alleviate the symptoms and prevent the possible morbidities. Conclusion: Intranasal teeth are a rare form of ectopic teeth encountered to otolaryngology clinic and may cause a variety of symptoms and complications. CT is very useful; it confirms the diagnosis and facilitates surgical planning. Early diagnosis and treatment are very important to avoid their possible complications. Highlights:

The aim of this study is to illustrate the managements of different clinical and radiological presentations of serious complications of frontal sinusitis diagnosed and managed at the tertiary referral hospital. A case series study conducted at the tertiary referral in the period from 2012 to 2019. Four different cases of serious complications of frontal sinusitis namely orbital abscess, frontal meningitis, subdural empyema and frontal lobe abscess will be presented and discussed. Despite the generous use of antibiotics, the serious complications of frontal sinusitis still develop. The serious complications of frontal sinusitis ranges from orbital abscess to frank frontal lobe abscess. The management is a combination of systemic antibiotics and surgical drainage with excellent outcomes.

Introduction: Sinonasal schwannoma accounts for only 4% of head and neck nerve sheath tumors. Schwannoma of the nasal septum is still the rarest, with only few cases previously reported. Case presentation: This study presents the case of a 64-year-old Saudi female of the Eastern Province who presented a several-month history of unilateral progressive nasal obstruction and recurrent episodes of epistaxis. The diagnosis of nasal septal schwannoma was made on the basis of a histopathological examination. The case was managed successfully by endoscopic endonasal excision with no postoperative recurrence. Discussion: Nasal septal schwannoma is rare and has only 32 reported cases. Diagnosis primarily depends on histopathological examination. Endoscopic endonasal excision of the mass is considered the ideal treatment for such pathology. Conclusion: Schwannoma of the nasal septum is rare. However, it should be included as a differential diagnosis in a patient presenting with a unilateral nasal mass. Highlights:

This article presents a rare case report of an ectopic third molar tooth located in the medial wall of maxillary sinus in a young male manifesting as recurrent sinusitis along with upper jaw pain and postnasal discharge diagnosed with an ectopic tooth and bilateral dentigerous cysts. This article aims to discuss this rare presentation of an ectopic tooth as a cause of recurrent maxillary sinusitis and the endonasal endoscopic management of the case.

Background. Fungal ball sinusitis is a sinonasal fungus ball that usually affects immunocompetent adults with female predominance. The most affected sinus is the maxillary sinus. Aspergillus species is the most typically found fungus. Computed tomography (CT) scan is the gold standard tool in order to diagnose fungal ball sinusitis. The ultimate method for a fungal ball is functional endoscopic sinus surgery (FESS), which has a high success rate and a low morbidity rate. Objective. This study aims to demonstrate the various clinical presentations of fungal ball sinusitis including isolated maxillary sinus, sphenoid sinus, simultaneous occurrence of maxillary and sphenoid fungal ball, and post endonasal endoscopic pituitary surgery fungal ball with various age groups. Also, this study aims to emphasize the importance of early diagnosis and treatment in such cases. Patients and Methods. A retrospective study that was carried in the otorhinolaryngology department of two hospitals: King Fahad Specialist Hospital and Qatif Central Hospital, Eastern Region, Saudi Arabia. The study was conducted on a total of 16 patients who were diagnosed with paranasal sinuses fungal ball in an 11-year period from January 2008 and November 2019. Results. Out of 16 patients with paranasal sinuses fungal ball, 11 cases were female and 5 males, with age ranging between 16 and 46 years. Results showed eight isolated sphenoid (50), six isolated maxillary fungal ball (38), one simultaneous occurrence of the sphenoid and maxillary fungal ball (6), and one post endonasal endoscopic pituitary surgery for pituitary adenoma (6). CT scan was performed for all 16 cases which is the standard tool for the diagnosis of the fungal ball. Conclusion. Fungal ball may present with variety of symptoms but most commonly with postnasal discharge (PND), headache, and facial pain. CT sinuses is the diagnostic radiological modality to confirm the diagnosis. The FESS functional endoscopic sinus surgery is the gold safe approach for patients with fungal ball to manage their symptoms, confirm the diagnosis, and removal of disease with no morbidities.