Department of Otorhinolaryngology, Christian Medical College, Vellore, India.
Department of Pathology, Christian Medical College, Vellore, India.
Mycoses. 2021 Dec;64(12):1471-1479. doi: 10.1111/myc.13381. Epub 2021 Oct 28.
Rhinosporidiosis is a chronic granulomatous disease of the nose caused by Rhinosporidium seeberi. The disease is largely non-amenable to medical therapy and shows high recurrence rates requiring patients to undergo multiple surgeries often resulting in increased morbidity.
To analyse the epidemiological, clinical, histopathological characteristics, treatment and outcome in rhinosporidiosis and to identify factors which predispose to recurrence of the disease.
PATIENTS/METHODS: Retrospective analysis of data of all patients with a diagnosis of rhinosporidiosis confirmed by histopathology at a tertiary care hospital from 2015 to 2019.
There were 42 patients, 40 males and two females, with a mean age of 37.37 years. Disease showed bilateral involvement in 17 (40.48%) patients. Nineteen (45.24%) patients had more than two sites involved at initial presentation. Most patients had nasal cavity involvement followed by nasopharynx. Among the 28 patients who had a follow-up, 12 showed recurrent disease. However, 21 patients were disease free following a revision excision. Involvement of more than two sites was an independent significant factor for recurrence. On univariate analysis, other factors which showed statistically significant odds of developing recurrence were previous surgery (p = .054), involvement of nasal septum (p = .022), middle turbinate (p = .024), nasopharynx (p = .049) and posterior pharyngeal wall (p = .05). Factors which showed significantly less likelihood of developing a recurrence included patients who had less than 12 months duration from first symptom to intervention (p = .016), involvement of less than two sites (p = .0003) and unilateral disease (p = .019).
Early intervention in rhinosporidiosis especially when the disease is unilateral and involves less than two sites improves the outcome.
鼻孢子菌病是一种由鼻孢子菌引起的鼻部慢性肉芽肿性疾病。该病在很大程度上不能通过药物治疗，且复发率高，需要患者多次手术，这往往会导致更高的发病率。
分析鼻孢子菌病的流行病学、临床和组织病理学特征、治疗方法和转归，并确定导致疾病复发的相关因素。
患者/方法：回顾性分析 2015 年至 2019 年期间在一家三级护理医院经组织病理学确诊为鼻孢子菌病的所有患者的数据。
共纳入 42 例患者，男 40 例，女 2 例，平均年龄 37.37 岁。17 例（40.48%）患者疾病呈双侧受累。19 例（45.24%）患者初诊时存在超过 2 个部位受累。大多数患者的病变部位位于鼻腔，其次为鼻咽部。在 28 例获得随访的患者中，12 例出现疾病复发。但 21 例经再次切除后疾病痊愈。多部位受累是疾病复发的独立显著因素。单因素分析显示，其他具有统计学意义的疾病复发风险因素包括：既往手术史（p=0.054）、鼻中隔受累（p=0.022）、中鼻甲受累（p=0.024）、鼻咽部受累（p=0.049）和后咽部受累（p=0.05）。而具有较低复发风险的因素包括：首次出现症状至干预的时间间隔小于 12 个月（p=0.016）、受累部位少于 2 个（p=0.0003）和单侧病变（p=0.019）。
鼻孢子菌病的早期干预，特别是当疾病为单侧、受累部位少于 2 个时，可改善预后。
