Virtual Patients - Rhinology - Epistaxis

The second pack is placed, with good haemostais achieved. Your nasal anatomy knowledge allows you to reassure both patient and other staff the blood from the eye is actually coming from the nasolacrimal apparatus and should settle. 

After 24 hours in-situ the packs are removed and nasal cautery is successfully conducted. The patient is discharged home with Naseptin nasal cream. Outpatient follow up is booked for 1 month.

 

During the follow-up consultation, the patient reports further smaller bleeds from both nostrils. Due to some red flag risk factors for nasopharyngeal cancer in the patient's history, the consultant decides to conduct a nasal scope on the patient. 

Question

 

Which of the following are not a risk factor for nasal carcinoma?