Rhinopsporidiosis and Laser Treatment
RhinosporidiosisÂ is a chronic granulomatous disease of the nose characterized by friable, highly vascular, sessile or pedunculated polyps that may appear in the nasal cavity. The etiologic agent being described as Rhinosporidium Seeberi.
The disease was first described by Seeber (1900) in Argentina. This fungal pathogen commonly affects mucosa of nose, eye and upper aero-digestive tract of men and animals. The color varies from pink to purplish red, and close examination of the surface may reveal minute white sports which are the mature sporangia of the fungus.
Diagnosis is mainly based on clinical suspicion and histopathological confirmation.
Most of the early studies of Rhinosporidiosis were made in India and Ceylon where the disease occurs frequently. Infections are seen most often in laborers and in those with frequent exposure to water of streams and pools. The frequent history of prior extended to water of pools and rivers and the occurrence of multiple cases among those members of a group of workmen most intimately and repeatedly exposed to water source suggest the R. Seeberi has a natural habitat in water.
On the examination of the gross tissue, unless Rhinosporidiosis has been suggested by the clinician, or by the history of the patient’s geographic residence, the pathologist may consider the specimen an ordinary nasal polyp.
The correct diagnosis can usually be made without difficulty on examination of routine H and E stained slide. Under the scanning lens of the microscope, although the polypoid structure may be evident, the histopathologic pattern differs greatly from that of the common nasal polyp.
At present, no existing medical treatment cures the disease and endoscopic excision of the mass with cauterization of the base is considered as treatment of choice.
Medical treatment with dapsone, an antileprosy drug was tried but not helpful.
Endonasal excision with electric cautery is widely done, but recurrence rate is high.
The other option is laser treatment of the lesions by Co2 laser. All precautions are taken, not to spill any blood to the nasopharynx and avoid contamination of other areas.
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