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鼻硬结病全景综述——二十年鼻部自然致残经历

The Panoramic Overview of Rhinoscleroma - A Two-Decade Experience of Nature's Crucification of the Nose.

作者信息

Belaldavar B P, Patil P H, Havaldar Rajesh Radhakrishna, Bandyopadhyay Samrat, Tubachi Jagadish, Shiromany Amol, Khadilkar Meera, Bhat Manali, Belaldavar Manish B

机构信息

Department of Otorhinolaryngology and Head & Neck Surgery, J. N. Medical College, KLE Academy of Higher Education & Research, Belagavi, Karnataka 590010 India.

A.M. Medical Centre, 97A, Southern Ave, Kalighat, Kolkata, West Bengal 700029 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2025 May;77(5):2061-2069. doi: 10.1007/s12070-025-05448-x. Epub 2025 Apr 11.

Abstract

Rhinoscleroma is a chronic granulomatous disfiguring disease affecting the nose. With its 3 known stages and characteristic histopathological features, the condition is still difficult to treat since its difficult to diagnose many a times. This is a case series of 14 patients who presented to a tertiary care referral hospital over a period of two decades. The spectrum of involvement ranged between presence of nodules in the nostrils to oropharyngeal involvement. Patients were many a times misdiagnosed outside and undergone unnecessary surgeries like septoplasty leading to septal perforation and crusting in the nasal cavities. It is important to be watchful of Rhinoscleroma especially when conventional treatments have failed and avoid unnecessary surgeries in patients. Medical line of management should always precede definitive surgical corrections in order to burn out the active disease. Using the surgical planes helps to release the fibrosis and create adequate space for sinus drainage. Along with patience, a close follow up is needed to monitor recurrence and treat it in time.

摘要

鼻硬结病是一种影响鼻子的慢性肉芽肿性毁容性疾病。鉴于其已知的三个阶段和特征性组织病理学特征,该病仍难以治疗,因为很多时候难以诊断。这是一组病例系列,包含20年间在一家三级转诊医院就诊的14例患者。受累范围从鼻孔出现结节到口咽受累不等。患者多次在院外被误诊,并接受了诸如鼻中隔成形术等不必要的手术,导致鼻中隔穿孔和鼻腔结痂。尤其在传统治疗失败时,警惕鼻硬结病很重要,应避免对患者进行不必要的手术。在进行确定性手术矫正之前,应始终先采用药物治疗方法来消除活动性疾病。利用手术层面有助于松解纤维化,并为鼻窦引流创造足够的空间。除了要有耐心外,还需要密切随访以监测复发情况并及时进行治疗。

相似文献

1
The Panoramic Overview of Rhinoscleroma - A Two-Decade Experience of Nature's Crucification of the Nose.鼻硬结病全景综述——二十年鼻部自然致残经历
Indian J Otolaryngol Head Neck Surg. 2025 May;77(5):2061-2069. doi: 10.1007/s12070-025-05448-x. Epub 2025 Apr 11.

本文引用的文献

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Long-term follow-up of repair of external nasal deformities in rhinoscleroma patients.对硬肿病患者鼻部外部畸形修复的长期随访。
J Craniomaxillofac Surg. 2018 Dec;46(12):2138-2143. doi: 10.1016/j.jcms.2018.09.024. Epub 2018 Sep 26.
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Traumatic nasal injuries in general practice.
Aust Fam Physician. 2016 Sep;45(9):650-3.
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Rhinoscleroma of nose extruding into oral cavity.鼻硬结病向口腔内突出
J Coll Physicians Surg Pak. 2015 Apr;25 Suppl 1:S27-9.
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Rhinoscleroma: a case series report and review of the literature.鼻硬结病:病例系列报告及文献综述
Eur Arch Otorhinolaryngol. 2014 Jul;271(7):1851-6. doi: 10.1007/s00405-013-2649-z. Epub 2013 Aug 1.

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