Three Years’ Experience of Management of Different Types of Rhinosporidiosis in Rural Part of Western West Bengal

Abstract

Introduction: The incidence of different types of rhinosporidiosis is very high in the rural western part of West Bengal. The treatment of choice is surgical excision and cauterization of the base. The recurrence rate is very high.
 Aims and objectives: The objectives of this study were to assess the distribution of rhinosporidiosis according to age, sex, presenting features, site of origin, recurrence rate and compare them with literature; and describe the surgical technique to reduce recurrence of the disease.
 Materials and methods: This prospective case study was done in the department of Otorhinolaryngology in a tertiary care hospital in the western part of West Bengal from April 2012 to March 2015. Wide local excision of rhinosporidiosis along with electrocautery of the base was done. We took the help of endoscope and microscope whenever needed. Regular follow up with endoscope was done in postoperative period.
 Results: Out of total 112 patients 62 were male and 50 were female. Commonest age group affected was 2nd decade. There was no recurrence in patients undergoing operation for the first time. Recurrence was noted in nasopharynx of 3 patients undergoing revision surgery.
 Conclusion: Complete removal of rhinosporidiosis from the base is the basic criterion to reduce recurrence. It is possible by using meticulous technique along with the guidance of endoscope or microscope whenever needed. Regular postoperative follow up with endoscope is must to detect and treat early recurrence.

Rhinosporidiosis- A retrospection

“…11 In a study done by Karthikeyan P et al, from Pondicherry and Chakraborty D et al from west Bengal, male to female ratio was 1.3:1 and 1.24:1 respectively, suggesting an equal incidence in males and females. 1,3 The male preponderance in the present and most of the studies is probably related to more outdoor activity in agriculture in males, while females having lesser chance of animal contact and less frequent pond baths. Some authors are also of the opinion that estrogen in females may provide some protection from the disease.…”

“…Similar findings were observed in Karthikeyan P, Bhandary S and Chakraborty D in their studies. 1,3,11 Nasal cavity was the most common location of rhinosporidiosis in our study. Only nasal cavity lesions were seen in 19 cases (55.9%), nasal & nasopharyngeal lesions in 5 patients (14.7%) and disseminated (Nasal or nasopharyngeal with cutaneous lesions) in 4 patients (11.76%).…”

“…72%). Inferior turbinate was also the commonest site observed by Majumdar AB et al while septum was the commonest site in studies done by Karthikeyan P et al, Chakraborty D et al and Mahmud S et al 1,3,8,14 Lateral nasal wall was the commonest location reported by Bhandary S et al 11 Nasal obstruction was the most common presenting complain (34.42%), followed by nasal mass (9.8%) and mass in the throat (9.8%) and bleeding from nose (8.19%). Mahmud S et al also found similar finding in their study.…”

“…8,11 There was a low incidence of Rhinosporidiosis in children and older age group in our study which was similar to most of the studies. 8,3 Natural habitat of R.seeberi is stagnant water like ponds, back waters and reservoirs and hence the river sand workers and people indulged in agricultural work who bathed in ponds where animals also bathed combined with digital microtrauma are at risk of developing rhinosporidiosis especially of upper respiratory tract and eye. [9][10][11] All of patients in our study were agriculturists and all had history of bathing in ponds, rivers or reservoirs.…”

“…In India, it is endemic in coastal areas of Orissa, Tamilnadu, Kerala, Karnataka and Pondicherry states. 3 Mode of infection from the natural aquatic habitat of R.seeberi is through the traumatized epithelium most commonly in nasal sites. Mode of local spread in the upper respiratory sites is by auto-inoculation while hematogenous spread occurs to distant sites.…”