Madana J, Yolmo Deeke, Gopalakrishnan S, Saxena Sunil K
Division of Head and Neck Oncology, Jewish General Hospital, Montreal, QC H3T 1E2, Canada.
Ear Nose Throat J. 2013 Jul;92(7):E27-30. doi: 10.1177/014556131309200718.
Rhinosporidiosis is a chronic granulomatous disease caused by Rhinosporidium seeberi. It usually affects mucous membranes of the nose, nasopharynx, and ocular conjunctiva. Cutaneous, laryngeal, tracheal, genital, and bony dissemination is rare. Laryngotracheal involvement poses many diagnostic and therapeutic challenges. A 45-year-old South Indian man presented with complaints of a mass in both nostrils for 2 years, associated with progressive hoarseness of voice and difficulty in breathing for 6 months. Rhinosporidial lesions were seen bilaterally in the nasal cavity. Telescopic and fiberoptic laryngoscopic examinations showed reddish, strawberry-like masses with whitish spots on their surface involving the larynx and trachea. Computed tomography of the head and neck revealed soft-tissue mass lesions involving the bilateral nasal cavities and nasopharynx, extending to the oropharynx and involving the larynx and trachea. A preliminary tracheostomy was performed, followed by direct laryngoscopic excision of the laryngeal lesions and rigid-bronchoscopy-guided excision of the tracheal lesions. The patient was prescribed dapsone and advised to take it for 2 years. At 2 years of follow-up, there was no recurrence.
鼻孢子虫病是一种由西伯鼻孢子菌引起的慢性肉芽肿性疾病。它通常累及鼻、鼻咽和眼结膜的黏膜。皮肤、喉、气管、生殖器和骨的播散很少见。喉气管受累带来了许多诊断和治疗挑战。一名45岁的南印度男子主诉双侧鼻孔肿物2年，伴有进行性声音嘶哑和呼吸困难6个月。鼻腔双侧可见鼻孢子虫病变。伸缩式和纤维喉镜检查显示喉部和气管有红色、草莓样肿物，表面有白色斑点。头颈部计算机断层扫描显示软组织肿物累及双侧鼻腔和鼻咽，延伸至口咽，累及喉和气管。先行气管切开术，随后直接喉镜下切除喉部病变，并在硬支气管镜引导下切除气管病变。给患者开了氨苯砜，并建议服用2年。随访2年，无复发。
