Sarcoidosis is a multisystem disorder of unknown etiology that is characterized by the formation of noncaseating granulomas in various affected tissue systems. Sarcoidosis of the upper respiratory tract (SURT) is generally considered to be uncommon.1,2 Recent studies, however, indicate that the upper respiratory tract involvement in sarcoidosis may be more frequent than is generally realized and causes most persistent and disabling manifestations.3,4 In an elegant study of 17 patients with SURT, the nasal mucosa was affected in all: the pharynx and larynx were less commonly involved.5
HOW DOES ONE SUSPECT UPPER RESPIRATORY TRACT INVOLVEMENT IN SARCOIDOSIS?
In taking a history of a sarcoidosis patient, always ask the question "Do you have any nasal stuffiness or congestion?" If the answer is yes, do not ignore it. It may be the first symptom of SURT. When one obtains a biopsy specimen of nasal mucosa in such cases, it almost