NOSE - Rhinosporiodosis

What is Rhinosporiodosis?

Rhinosporiodosis is a chronic fungal infection of the mucous membrane of the nose and nasopharynx but occasionally involving the lips, palate, uvula, sinuses, larynx and skin.

What is the Aetiology of Rhinosporiodosis?

1. Geographical distribution: Commonly seen in endemic areas of India and Sri-Lanka.
2. Age: Young males are usually affected
3. Occupation: Persons having a close association with cattle and  animals are usually affected.

Causative Organism:
The disease is caused by the fungus Rhinosporidium Seeberi.

Modes of transmission:
(a) Air borne: Dust dung of infected cattle
(b) Water borne: Bathing in contaminated waters.

Symptoms:
(1) Epistaxis with viscid nasal discharge
(2) Nasal Blockage
(3) Difficulty in swallowing can occur when the characteristic polyps grow posteriorly.

Signs:       
(1) Anterior rhinoscopy, reveals, friable strawberry like, masses studded with sporangia.
(2) Extent: The masses may spread from the nasal septum, vestibule, and to the nasopharynx.
(3) The mass is extremely friable and bleeds on touch.

 

Histology:
Microscopic examination of the nasal discharge will show spores.
The polyps has a vascular fibromyxomatous disease with round or oval cells containing sporangium.

What is the Treatment of Rhinosporiodosis?

  Various medical treatments has been tried
(1) Diaminodiphenyl sulphone (Dapsone) orally
(2) Local Injection of depot corticosteroids
(3) Systemic Amphotericin B.

Surgical:       
Surgical excision can be done with diathermy knife, cryosurgery, or laser surgery, during surgery; cauterization of the base of the pedicle is advocated.

Recurrence rate is high. During surgical excision, utmost care of asepsis must be taken as the spores can given rise to new seedling to the patient and as well as operating staff.

Surgical removal by FESS:

FESS helps in minimizing the recurrence rate, as the pedicle can be removed or cauterized under direct vision.



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