​Clinical Spectrum of Otorhinolaryngological Manifestations in Leprosy: A Retrospective Analysis from Jammu and Kashmir

ABSTRACT

Introduction: Leprosy is a chronic infectious granulomatous disease caused by Mycobacterium leprae, also known as Hansen’sdisease. The disease affects the peripheral nervous system, skin, and mucous membrane. Dissemination and transmission ofM. leprae are primarily from nasal mucosa of infected persons.Materials and Methods: A record-based retrospective observational study was done in the Department of Dermatology andENT, ASCOMS Hospital, Jammu, Jammu and Kashmir, to know the prevalence of otorhinolaryngological manifestations ofleprosy using records of 49 leprosy patients retrieved for 5 years from 2013 to 2018.Results: Forty-nine patients with 40 (82%) males and 9 (18%) females were included in the study having male–to-female ratio4.51. A majority of the patients (47%) were in the age group of 20–40 years. Forty-seven (96%) patients had a multibacillarytype of leprosy, while only 2 (4%) patients had paucibacillary leprosy. Seven (14%) patients showed reaction. Four (8%) showedtype I and 3 (6%) showed type II reaction. Nasal manifestations were predominantly encountered among the otorhinolaryngealmanifestations. All the otorhinolaryngeal manifestations were in the multibacillary type of leprosy. The main nasal symptomswith which patients presented were nasal stuffiness (14%), crust formation (8%), and recurrent mild epistaxis (6%). On anteriorrhinoscopy, mucosal changes (pale mucosa and edema) and nasal crusting were seen in 7 (14%) patients, atrophic conchawas seen in 3 (6%) patients and ulceration of the septal perforation was seen in 2 (4%) patients. Saddle nose deformity wasseen in 1 patient. Among the otological manifestations, two patients had erythematous nodules on pinna, while diffuse infiltrationof ear lobules was noted in five patients. Labial edema was seen in two patients and nodular lesion on the lip in one patient.Conclusion: Among the otorhinolaryngological manifestations, nasal involvement was the most commonly seen in leprosypatients. An otolaryngological examination should be routinely done in the diagnosed patients of leprosy