Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2020) – 128.41
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI – 0.5
Average rejection rate (2021) – 81.35%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

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Dental and Medical Problems

2017, vol. 54, nr 4, October-December, p. 435–439

doi: 10.17219/dmp/76848

Publication type: clinical case

Language: English

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Creative Commons BY-NC-ND 3.0 Open Access

Difficulties in diagnosing and treating nasal rhinoscleroma: A case study

Trudności w diagnostyce i leczeniu twardzieli błony śluzowej nosa – opis przypadku

Paweł Poniatowski1,A,B,C,D,E,F, Klaudiusz Łuczak1,B,D,F, Kamil Nelke2,B,D,E,F

1 Department of Maxillo-Facial Surgery, Wroclaw Medical University, Poland

2 Department of Maxillo-Facial Surgery, 4th Military Hospital, Wrocław, Poland

Abstract

For many years scleroma was considered to be a neoplastic tumor. First findings of this disease came from the 4th century. In the 18th century it was also called the leprosy of the nose. In 1840, a Polish surgeon was the first in the world to describe rhinoscleroma as a “chronic nose cancer”. In late 1877, Jan Mikulicz-Radecki classified this scleroma as rhinoscleroma, an inflammatory disease with the most common occurrence in the nasal cavity. Because of very rare cases of this disease reported nowadays (endemic), its treatment is challenging. The disease manifests itself as a symptomatic mass causing mostly an obstruction of nasal breathing or even local nose bleeds, and infiltrates the surrounding structures of the nose and sinuses. Difficult accurate clinical diagnosis of this disease seems to be the main problem in its early detection and treatment. Apart from a surgical excisional biopsy or more radical surgical approach, additional antibiotic treatment, along with routine checkups by an infectious diseases specialist, should be maintained. A very rare and unusual case of a 75-year-old retired otolaryngologist diagnosed with a symptomatic mass in the nasal cavity, treated previously by unknown methods and without any success, will be presented. It is worth noticing that either the patient’s economic status or his past job as an otolaryngologist might be related to the occurrence of rhinoscleroma as the possible route of infection.

Key words

rhinoscleroma, nasal cavity, diagnostic difficulties, treatment outcomes

Słowa kluczowe

twardziel błony śluzowej nosa, jama nosowa, trudności diagnostyczne,wyniki leczenia

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