Scleroma of the larynx

Abstract

Twenty-two cases of rhinoscleroma were studied to determine the involvementof the larynx. The study revealed that scieroma affected the larynx in 40 per cent of cases. In the larynx, scleromatous lesions were found in the subglottic region and the disease was observed in stages i.e. atrophic, granulomatous (proliferative i.e. nodular) and afibrotic or sclerotic (scarring) stage as found in the nose. The role of laryngological examination is established in the diagnosis of asymptomatic and early laryngeal lesions and in assessing response to initial treatment. Extensive granulomatous lesions were treated by open excision by the laryngofissure approach which was found to be the best method resulting in a quick recovery without any evidence of subglottic stenosis. The disease as a whole is discussed in the light of available literature.

Rhinoscleroma: A French National Retrospective Study of Epidemiological and Clinical Features

“…RS is also rare in the United States, but recent reports suggest an increase in cases because of migration from endemic areas [22]. Regions with high endemicity (e.g., Guatemala [23], El Salvador [24], Mexico [25], Colombia [26], and Egypt [27]) have hundreds of reported cases. Within those countries, the endemic areas tend to remain well defined and are often quite small [17,26,28].…”

Airway scleromas and their extensions

“…Few cases of involvement of the tracheal and bronchial tree from extension of disease from the nose have been reported . We encountered one case with tracheal narrowing by fibrosis below the subglottic and 16 other cases in the atrophic and granulomatous stage of the disease.…”

“…Laryngeal lesions in the atrophic stage can be arrested by the use of an effective antibiotic . When scaring of the larynx occurs, it is commonly treated by repeated dilatation or removal of obstructing adhesions .…”

The Wonderful World of the Windpipe: A Review of Central Airway Anatomy and Pathology

“…Rhinoscleroma is a chronic granulomatous infection due to Klebsiella rhinoscleromatis that affects the respiratory epithelium from the nose to the bronchi. Laryngeal involvement has been reported to occur in 15%-80% of cases [26].…”