Das Chiranjib, Das Sudip Kumar, Chatterjee Pritam, Bandyopadhyay Saumendra Nath
BSMCH, Bankura, West Bengal India.
2CMC, Kolkata, West Bengal India.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 3):1863-1870. doi: 10.1007/s12070-018-1270-2. Epub 2018 Feb 12.
Rhinosporidiosis is a chronic granulomatous disease caused by . It usually presents as sessile or pedunculated granular polyp, red in colour with multiple yellowish pin-head sized dots. Atypical presentations due to involvement of extra-nasal sites may produce diagnostic dilemma. Very high incidence of rhinosporidiosis and that too with atypical presentations in the rural western part of West Bengal, encourages us to undertake this study. The present study was conducted in a tertiary care hospital in the rural western part of West Bengal from July 2013 to December 2016. Patients presenting with rhinosporidiosis in extra-nasal sites and with atypical presentations were included in the study. Rhinosporidiosis confined to nose and patients who lost follow up were excluded from the study. All patients were treated with wide excision and cauterization of base. Among total 114 patients of rhinosporidiosis, 16 had atypical presentations (14.04%). Nine patients (56.25%) presented with a mass hanging in the oropharynx, some mimicking oropharyngeal malignancy. Two patients (12.50%) presented with acute respiratory distress and stridor. One patient (6.25%) presented with disseminated rhinosporidiosis with involvement of the skin, subcutaneous tissue, muscle, bone, penis and urethra. Recurrence was noted in only two patients (12.50%) in nasopharynx. This chronic disease may present with different acute presentations. Proper clinical eye may avoid pre-operative biopsy which may lead to extensive bleeding. Recurrence can be reduced with meticulous and complete removal. Regular post-operative follow-up with endoscopy is must to detect and treat early recurrence.
鼻孢子虫病是一种由……引起的慢性肉芽肿性疾病。它通常表现为无柄或有蒂的颗粒状息肉,颜色发红,有多个针头大小的淡黄色斑点。由于鼻外部位受累导致的非典型表现可能会造成诊断难题。西孟加拉邦西部农村地区鼻孢子虫病的发病率非常高,而且非典型表现也很常见,这促使我们开展这项研究。本研究于2013年7月至2016年12月在西孟加拉邦西部农村的一家三级护理医院进行。研究纳入了鼻外部位出现鼻孢子虫病以及有非典型表现的患者。局限于鼻腔的鼻孢子虫病患者以及失访患者被排除在研究之外。所有患者均接受了广泛切除并烧灼基底的治疗。在总共114例鼻孢子虫病患者中,16例有非典型表现(14.04%)。9例患者(56.25%)表现为悬垂于口咽的肿物,有些类似口咽恶性肿瘤。2例患者(12.50%)出现急性呼吸窘迫和喘鸣。1例患者(6.25%)表现为播散性鼻孢子虫病,累及皮肤、皮下组织、肌肉、骨骼、阴茎和尿道。仅2例患者(12.50%)在鼻咽部出现复发。这种慢性病可能会有不同的急性表现。仔细的临床观察可以避免术前活检,因为活检可能导致大量出血。通过细致彻底的切除可以减少复发。术后必须定期进行内镜随访,以便早期发现和治疗复发。