A healthy 15-year-old male patient presented with several years of bilateral congestion and hyposmia. He and his family denied facial trauma, recent or recurrent sinusitis, rhinorrhea, difficulty breathing, pain, change in vision, and constitutional symptoms. He had never had allergy testing but did have occasional allergic symptoms, including sneezing and itchy eyes and nose. He did not report any drug, alcohol, or tobacco use. He was developmentally normal. On physical examination, the patient appeared healthy and had a normal-sounding voice. The tonsils were small, without crypts or tonsilloliths, and there were no neck masses.