Imaging of scleroma in the head and neck

Abstract

We review the appearance of scleroma in the head and neck on imaging. Scleroma is a chronic granulomatous disease that primarily affects the nasal cavity, but the pharynx and larynx may also be involved. On imaging, nasal scleroma appears as bilateral or unilateral expanded homogeneous nasal masses that may exhibit hyperintense signal on T(1) weighted images. Pharyngeal scleroma commonly narrows the pharyngeal lumen and may involve the soft and hard palate. Imaging is essential to detect the extent of subglottic stenosis in patients with laryngeal scleroma. Rarely, scleroma may involve the orbit or the middle ear. Imaging is essential for the early diagnosis of scleroma and for differentiating it from other granulomatous and neoplastic lesions. Also, imaging is important for treatment planning and follow-up of patients after therapy.

Report of a case of giant rhinoscleroma: CT and MRI

“…Rhinoscleroma is a chronic granulomatous bacterial disease of the nose that can sometimes infect the upper respiratory tract. 1 It is caused by gram-negative bacillus Klebsiella rhinoscleromatis . 1 Rhinoscleroma predominantly involves the nasal mucosa, but it can also involve the larynx; nasopharynx; oral cavity; paranasal sinuses; trachea, bronchi or soft tissues of the lips and nose.…”

“…1 It is caused by gram-negative bacillus Klebsiella rhinoscleromatis . 1 Rhinoscleroma predominantly involves the nasal mucosa, but it can also involve the larynx; nasopharynx; oral cavity; paranasal sinuses; trachea, bronchi or soft tissues of the lips and nose. 2 Our patient had large extensive masses with the involvement of multiple sites that included the nose, nasopharynx, paranasal sinuses, left orbit, oropharynx, and larynx.…”

“…Rhinoscleroma is usually classified clinically and pathologically into the following three stages: the catarrhal (or atrophic) stage, the proliferative (or granulomatous) stage, and the fibrotic (or sclerotic) stage. 1…”

Rhinoscleroma: An unusual presentation

“…[ 15 ] Rhinoscleroma usually occurs at the epithelial transition zones, especially at the junction where stratified squamous epithelium of the vestibule meets ciliary epithelium of the nose. [ 16 ]…”

Orphan diseases of the nose and paranasal sinuses: Pathogenesis – clinic – therapy

“…After healing, reconstructive surgery of functional and/or esthetic reasons may be necessary. However, it should be noted that recurrences are frequent (up to 25% in 10 years) [ 7 ], [ 39 ], [ 40 ], [ 41 ], [ 42 ], [ 43 ], [ 44 ].…”