Published June 30, 2024 | Version https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue6,Article285.pdf
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Laryngotracheal Rhinosporidiosis: A Case Study

Authors/Creators

  • 1. Professor and HOD of ENT, Department of ENT, Andhra Medical College, Visakhapatnam, AP
  • 2. Associate Professor of ENT, Department of ENT, Andhra Medical College, Visakhapatnam, AP
  • 3. Postgraduate student in ENT, Department of ENT, Andhra Medical College, Visakhapatnam, AP
  • 4. Assistant Professor of ENT, Department of ENT, Andhra Medical College, Visakhapatnam, AP
  • 5. Senior Resident in ENT, R, Department of ENT, Andhra Medical College, Visakhapatnam, AP

Description

Background: Rhinosporidiosis is a chronic granuloma occurring in almost all parts of the body resulting due to infection of Rhinosporidium seeberi. Most common sites are mucous membrane of nose and nasopharynx, but also occur in other sites like oral mucosa, lips, palate, trachea, larynx, lacrimal sac, penis, scalp, skin, vulva and bone. Rhinosporidium seeberi survive in water bodies in few endemic areas with its spread mainly dominated by Natural trans-epithelial penetration. Demonstration of the organism confirmed from the pathological sites either by direct examination or by histopathological microscopy confirms the disease. Treatment consists of total excision and cauterization of its base. Among the sites mentioned Larynx is one of the rarest sites. Aim of the Study: To present an unusual case of Rhinosporidiosis in multiple sites of Air passage successfully excised and confirmed on Histopathology. Materials: A male aged 44 years presenting with hoarseness of voice on examination showed a polypoidal mass on the aryepiglottic fold, Left vocal cord and subglottic region. Biopsy from all the sites was done which revealed on Histopathology as Rhinosporidiosis. Results: Micro laryngeal surgery under G.A. with cuffed endotracheal tube. Visualization achieved sinus endoscope attached to Storz camera and monitor.  Bleeding was present from multiple sites. Conclusions: Laryngotracheal involvement of Rhinosporidiosis poses many diagnostic and therapeutic challenges because of the potential for bleeding and aspiration. The present case could suggest a relationship between nasopharyngeal and laryngotracheal lesions in the form of systemic dissemination or spillage of spores from the nasopharynx into the larynx during previous episodes of bleeding and surgery. More studies are required to substantiate this possibility.

 

 

Abstract (English)

Background: Rhinosporidiosis is a chronic granuloma occurring in almost all parts of the body resulting due to infection of Rhinosporidium seeberi. Most common sites are mucous membrane of nose and nasopharynx, but also occur in other sites like oral mucosa, lips, palate, trachea, larynx, lacrimal sac, penis, scalp, skin, vulva and bone. Rhinosporidium seeberi survive in water bodies in few endemic areas with its spread mainly dominated by Natural trans-epithelial penetration. Demonstration of the organism confirmed from the pathological sites either by direct examination or by histopathological microscopy confirms the disease. Treatment consists of total excision and cauterization of its base. Among the sites mentioned Larynx is one of the rarest sites. Aim of the Study: To present an unusual case of Rhinosporidiosis in multiple sites of Air passage successfully excised and confirmed on Histopathology. Materials: A male aged 44 years presenting with hoarseness of voice on examination showed a polypoidal mass on the aryepiglottic fold, Left vocal cord and subglottic region. Biopsy from all the sites was done which revealed on Histopathology as Rhinosporidiosis. Results: Micro laryngeal surgery under G.A. with cuffed endotracheal tube. Visualization achieved sinus endoscope attached to Storz camera and monitor.  Bleeding was present from multiple sites. Conclusions: Laryngotracheal involvement of Rhinosporidiosis poses many diagnostic and therapeutic challenges because of the potential for bleeding and aspiration. The present case could suggest a relationship between nasopharyngeal and laryngotracheal lesions in the form of systemic dissemination or spillage of spores from the nasopharynx into the larynx during previous episodes of bleeding and surgery. More studies are required to substantiate this possibility.

 

 

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Dates

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2024-05-26

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