Nasal and sinus diseases are considered uncommon manifestations of sarcoido
sis. We evaluated 159 consecutive patients with sarcoidosis for nasal sympt
oms. Sixty-three patients (39%) denied any nasal symptoms. Thirty-six patie
nts (23%) had intermittent symptoms that lasted less than three weeks and r
equired continuous intervention with nasal steroids or normal saline. Sixty
patients (38%) were treated with nasal steroids and antibiotics for sympto
ms that lasted more than three weeks. Thirty-three patients (21%) had resol
ution of their symptoms after treatment with nasal steroids and antibiotics
. Twenty-seven patients (17%) had symptoms that were unresponsive to three
weeks of oral antibiotics and nasal steroids, and underwent CT scan. Based
on the CT results, five patients underwent biopsy, which confirmed sarcoido
sis. An additional patient who had a normal CT scan underwent a biopsy that
was consistent with sarcoidosis. A retrospective review of 733 sarcoidosis
patients was then performed and an additional 12 patients were identified
with biopsy-proven sarcoidosis. All of these patients required long-term th
erapy with prednisone (14 patients), methotrexate (13 patients), and/or aza
thioprine (8 patients). Our clinical study reveals a higher incidence of na
sal and sinus disease in patients with sarcoidosis than has previously been
described, and the recalcitrance of sarcoidosis when there is sinus involv
ement.