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Rhinosporidiosis of the upper airways and trachea

Published online by Cambridge University Press:  08 June 2010

J Madana ,
D Yolmo ,
S Gopalakrishnan  and
S Kumar Saxena
J Madana*
Affiliation:
Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
D Yolmo
Affiliation:
Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
S Gopalakrishnan
Affiliation:
Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
S Kumar Saxena
Affiliation:
Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
*
Address for correspondence: Dr J Madana, No. 22, Roja Street, Annai Theresa Nagar, Saram, Pondicherry 605013, India. E-mail: maddyy@gmail.com
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Abstract

Objective:

We report an extremely rare case of rhinosporidiosis with involvement of both larynx and trachea, together with coexisting nasal, nasopharyngeal and oropharyngeal lesions, in a 32-year-old man.

Method:

Case report and review of the world literature concerning laryngotracheal and disseminated rhinosporidiosis.

Results:

A 32-year-old, South Indian man presented with a nasal mass of four years' duration, with progressive hoarseness for one year. Strawberry-like rhinosporidial masses were seen in both nasal cavities. Fibre-optic laryngoscopic examination revealed reddish masses with whitish surface specks, involving the glottis, subglottis and trachea. Computed tomography revealed soft tissue opacities involving both nasal cavities and the nasopharynx and extending to the oropharynx, with involvement of the larynx and trachea. Direct laryngoscopy and rigid bronchoscopy guided excision of the laryngeal and tracheal lesions was performed.

Conclusion:

Rhinosporidiosis is a chronic, granulomatous disease which usually affects the mucous membranes of the nose and nasopharynx. Lower dissemination into the trachea is extremely rare. Laryngotracheal involvement poses many diagnostic and therapeutic challenges, due to the potential risk of bleeding and aspiration. In the presented case, local spread of rhinosporidiosis, due to direct spillage of spores from the nasopharynx into the larynx during episodes of bleeding or previous surgery, may have resulted in laryngotracheal involvement, although systemic spread cannot be excluded.

Keywords

RhinosporidiosisTracheaLarynx
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 10 , October 2010 , pp. 1139 - 1141
Copyright
Copyright © JLO (1984) Limited 2010

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