This retrospective case note review from Mount Sinai in New York looked at just 14 patients with sarcoidosis. Individual ENT units in the UK are likely to see relatively few of these patients, unless there is a major tertiary referral in the particular unit, so it is still interesting to view the experience of a group of patients of this size. The authors suggest a classification of the patients into four groups: atrophic / hypertrophic / destructive / nasal enlargement. This seems to me to be useful, as it reminds us of the wide variety of manifestations of sarcoidosis in the nose, with more than one pattern of behaviour. The authors emphasise that the vast majority of cases will be managed medically with relatively few requiring surgery.