Local iatrogenic complications in nasopharyngeal rhinoscleroma

Abstract

The possible role of surgical manipulation in inducing local spread and cicatricial complications in rhinoscleroma is illustrated by the three cases discussed in this paper. This is especially so where its occasional presentation as polypoid lesions of the lower respiratory tract may mimic other more sinister lesions and lead to unwarranted invasive procedures by the unsuspecting clinician. The infective nature of the lesions must be appreciated and confirmed microbiologically for appropriate drug treatment to be used. The benefits of minimal surgical intervention are illustrated in the third case.

Radiological diagnosis of rhinoscleroma—the ‘Palatal Sign’

“…In the report by Taha et al (1981), the characteristic palatal deformity is clearly identifiable in the only figure showing a lateral view of the postnasal space. In the report by Dawlatly et al (1988), the palatal sign is also seen in the only lateral projection of the postnasal space, it also forms part of the population of this study. It is noteworthy that all but one of the published radiographs were highlighting other features of rhinoscleroma and the palatal sign was just a chance finding.…”

Rhinoscleroma: A case report and a review of literature

“…Хирургическое вме шательство может быть произведено только после курса антибиотикотерапии и при отрицательных ре зультатах культурального исследования [24]. Следу ет учитывать, что антибиотики плохо проникают в ткани с недостаточным кровоснабжением и рубцы, поэтому при операциях по поводу РС необходимо антибактериальное «прикрытие» во избежание ятрогенной диссеминации процесса [25].…”

Imaging of scleroma in the head and neck

“…Pharyngeal involvement is seen in about one-third of patients with scleroma. Pharyngeal scleroma develops as a result of contiguous extension along the palate, lateral wall of the nasopharynx and faucial pillars [17,18]. The bulky granuloma projecting from the nasal cavity may deform the nasopharyngeal lumen ( Figure 2).…”

“…The bulky granuloma projecting from the nasal cavity may deform the nasopharyngeal lumen ( Figure 2). Also, the granuloma may creep around or obstruct the cartilaginous part of the Eustachian tube with retained secretions in the middle ear cavity [5,17]. The oropharyngeal lumen may be narrowed as a result of associated fibrosis, with subsequent calcification along the wall of the oropharynx with abscesses in the tonsillar regions ( Figure 4).…”