# Bilateral Nasolabial Cysts Mimicking Inferior Turbinate Hypertrophy in a Patient With Sinonasal Polyposis

## TL;DR

A patient with nasal obstruction was found to have rare bilateral nasolabial cysts mistaken for turbinate hypertrophy, successfully treated with endoscopic surgery.

## Contribution

Highlights the under-recognized possibility of bilateral nasolabial cysts mimicking turbinate hypertrophy in patients with sinonasal polyposis.

## Key findings

- Bilateral nasolabial cysts can be misdiagnosed as inferior turbinate hypertrophy on imaging.
- Endoscopic excision confirmed the diagnosis and provided a curative treatment.
- Retrospective imaging review is crucial to avoid misdiagnosis in similar cases.

## Abstract

Nasolabial cysts are rare, nonodontogenic cysts of the anterior nasal floor and nasolabial fold. Bilateral presentation is uncommon and may mimic inferior turbinate hypertrophy, leading to misdiagnosis. A 41-year-old Qatari man presented with a five-year history of persistent nasal obstruction, headache, and nasal discharge. He had chronic sinonasal polyposis and a prolonged history of topical nasal decongestant use, with poor response to intranasal steroids. Two CT scans performed three years apart were initially reported as showing sinonasal polyposis; however, retrospective review revealed subtle, bilateral, well-circumscribed anterior cystic lesions inferior to the inferior turbinates that had been overlooked. During functional endoscopic sinus surgery, symmetric bilateral nasolabial cysts measuring 1.5-2.5 cm were identified and excised endoscopically. Histopathology confirmed respiratory epithelium-lined cysts. Postoperative recovery was favorable, with no recurrence at 4.5 months. Bilateral nasolabial cysts are rare and can clinically and radiologically mimic inferior turbinate hypertrophy, especially in patients with rhinitis or sinonasal polyposis. Careful review of the anterior nasal cavity on imaging can prevent misdiagnosis. Endoscopic excision is both diagnostic and curative.