Paranasal sinuses involvement in rhinoscleroma, CT, endoscopic and histopathological study

ABSTRACT

Rhinoscleroma is a chronic granulomatous inflammatory disease of the upper respiratory tract of an insidous onset, slowly progressive course and benign in nature. This Study was conducted at Oto-Rhino-laryngology and Radiodiagnosis departments in Ain Shams University Hospitals. It included 50 rhinoscleroma patients, 28 females, 22 males, and their age ranged from 17-50 years. All patients were examined by CT-scans of paranasal sinuses, sinoscopy, and histopathological study of suspected tissues. Positive CT. findings were detected in 30 out of 50 cases [60%], while positive maxillary sinus lesions were seen by sinoscopy in 32 out of 50 [64%] in the form of thick polypoidal mucosa, granuloma and atrophic mucosa with secretions, while actual antroscleroma by the histopathological study was found in 11 cases [22%]. Anterior ethmoiditis with occlusion of osteomeatal complex was detected in 16 cases, while anterior and posterior ethmoiditis in 4 cases, sphenoid sinusitis was also seen in 3 cases by CT-scans. In this study, it was found, that CT-scan is reliable and helpfull diagnostic procedure in the detection of extent of rhinoscleroma in paranasal sinuses. Sinoscopy of the paranasal sinuses provided accurate information about the nature of mucosal changes, the presence of secretions and the state of natural ostium