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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
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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

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