Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-29T10:51:54.477Z Has data issue: false hasContentIssue false
  • English
  • Français

Chronic rhinosinusitis in ex-lepromatous leprosy patients with atrophic rhinitis

Published online by Cambridge University Press:  11 February 2013

J Suzuki ,
T Oshima ,
K Watanabe ,
H Suzuki ,
T Kobayashi  and
S Hashimoto
J Suzuki*
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan Department of Otolaryngology, National Sendai Medical Center, Sendai, Japan
T Oshima
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
K Watanabe
Affiliation:
Department of Otolaryngology, National Sendai Medical Center, Sendai, Japan
H Suzuki
Affiliation:
Department of Pathology, National Sendai Medical Center, Sendai, Japan
T Kobayashi
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
S Hashimoto
Affiliation:
Department of Otolaryngology, National Sendai Medical Center, Sendai, Japan
*
Address for correspondence: Dr Jun Suzuki, Department of Otorhinolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan Fax: +81 22 717 7307 E-mail: j_suzuki1212@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Aim:

Rhino-sinus mucosal involvement is well documented in untreated lepromatous leprosy, but less understood in ex-leprosy patients (i.e. leprosy patients who have been treated and cured) with atrophic rhinitis.

Materials and methods:

Rhino-sinus abnormalities were investigated in 13 ex-lepromatous leprosy patients with atrophic rhinitis, using interviews enquiring about sinonasal symptoms, nasal endoscopy, nasal swab culture and computed tomography. Endoscopic sinus surgery had been performed in three patients. The clinical course, computed tomography findings and nasal biopsy results of these three patients were evaluated.

Results:

All patients had turbinate atrophy and 6 of the 13 (46.2 per cent) had septal perforation. Paranasal sinus involvement was noted in 9 of 12 examined patients (75 per cent). The most commonly affected sinus was the maxillary sinus (in 8 of 12; 66.7 per cent). All three patients treated by endoscopic sinus surgery experienced relapse and required further surgery. Maxillary sinus irrigation was effective for reduction of persistent symptoms such as postnasal discharge and crusts.

Conclusion:

Ex-lepromatous leprosy patients with atrophic rhinitis had various rhino-sinus abnormalities and persistent symptoms. These patients had chronic rhinosinusitis because of underlying atrophic rhinitis. These patients required repeated otolaryngological observations together with combined surgery and conservative treatment.

Keywords

Leprosy, LepromatousNoseRhinitisSinusitisPathology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 3 , March 2013 , pp. 265 - 270
Copyright
Copyright © JLO (1984) Limited 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Kiris, A, Karlidag, T, Kocakoc, E, Bozgeyik, Z, Sarsilmaz, M. Paranasal sinus computed tomography findings in patients treated for lepromatous leprosy. J Laryngol Otol 2007;121:15–18CrossRefGoogle ScholarPubMed
2Soni, NK. Microscopic rhinoscopy in lepromatous leprosy. J Laryngol Otol 1997;111:122–4CrossRefGoogle ScholarPubMed
3Hietaharju, A, Croft, R, Alam, R, Birch, P, Mong, A, Haanpaa, M. Chronic neuropathic pain in treated leprosy. Lancet 2000;356:1080–1CrossRefGoogle ScholarPubMed
4Anonymous. Global leprosy situation, 2010. Wkly Epidemiol Rec 2010;85:337–48Google Scholar
5Chen, S, Chu, T, Wang, Q. Qualitative assessment of social, economic and medical needs for ex-leprosy patients living in leprosy villages in Shandong Province, The People's Republic of China. Lepr Rev 2005;76:335–47CrossRefGoogle ScholarPubMed
6Barton, RP. A clinical study of the nose in lepromatous leprosy. Lepr Rev 1974;45:135–44Google ScholarPubMed
7Srinivasan, S, Nehru, VI, Mann, SB, Sharma, VK, Bapuraj, JR, Das, A. Study of ethmoid sinus involvement in multibacillary leprosy. J Laryngol Otol 1998;112:1038–41CrossRefGoogle ScholarPubMed
8Srinivasan, S, Nehru, VI, Bapuraj, JR, Sharma, VK, Mann, SB. CT findings in involvement of the paranasal sinuses by lepromatous leprosy. Br J Radiol 1999;72:271–3CrossRefGoogle ScholarPubMed
9Soni, NK. Antroscopic study of the maxillary antrum in lepromatous leprosy. J Laryngol Otol 1989;103:502–3CrossRefGoogle ScholarPubMed
10Barton, RP. Radiological changes in the paranasal sinuses in lepromatous leprosy. J Laryngol Otol 1979;93:597–600CrossRefGoogle ScholarPubMed
11Lund, VJ, Mackay, IS. Staging in rhinosinusitus. Rhinology 1993;31:183–4Google ScholarPubMed
12Dutt, SN, Kameswaran, M. The aetiology and management of atrophic rhinitis. J Laryngol Otol 2005;119:843–52CrossRefGoogle ScholarPubMed
13Soni, NK. Intranasal anaesthesia in lepromatous leprosy. Trop Doct 1997;27:89–90CrossRefGoogle ScholarPubMed
14Chiu, AG, Kennedy, DW. Disadvantages of minimal techniques for surgical management of chronic rhinosinusitis. Curr Opin Otolaryngol Head Neck Surg 2004;12:38–42CrossRefGoogle ScholarPubMed
15Jiang, RS, Hsu, CY, Chen, CC, Jan, YJ, Jang, JW. Endoscopic sinus surgery and postoperative intravenous aminoglycosides in the treatment of atrophic rhinitis. Am J Rhinol 1998;12:325–33CrossRefGoogle ScholarPubMed
16Fang, SY, Jin, YT. Application of endoscopic sinus surgery to primary atrophic rhinitis? A clinical trial. Rhinology 1998;36:122–7Google ScholarPubMed
17Nakabayashi, S, Suzuki, H, Furukawa, M, Sasaki, N. Clinical characteristics of the sinonasal morbidity of leprosy patients [in Japanese]. Japanese Journal of Rhinology 1999;38:91–8Google Scholar
18Uren, B, Psaltis, A, Wormald, PJ. Nasal lavage with mupirocin for the treatment of surgically recalcitrant chronic rhinosinusitis. Laryngoscope 2008;118:1677–80CrossRefGoogle ScholarPubMed
19Abdel-Hak, B, Gunkel, A, Kanonier, G, Schrott-Fischer, A, Ulmer, H, Thumfart, W. Ciliary beat frequency, olfaction and endoscopic sinus surgery. ORL J Otorhinolaryngol Relat Spec 1998;60:202–5CrossRefGoogle ScholarPubMed
20Lund, VJ, Scadding, GK. Objective assessment of endoscopic sinus surgery in the management of chronic rhinosinusitis: an update. J Laryngol Otol 1994;108:749–53CrossRefGoogle ScholarPubMed
21Tomooka, LT, Murphy, C, Davidson, TM. Clinical study and literature review of nasal irrigation. Laryngoscope 2000;110:1189–93CrossRefGoogle ScholarPubMed