Endoscopic-assisted laser therapy for extensive rhinoscleroma

Abstract

EnAbstract Background Scleroma is a granuloma affecting mainly the nose, and may extend to affect the pharynx, the larynx, the lacrimal apparatus, and many soft tissue structures surrounding the nose. In Egypt, as in many other Eastern countries, scleroma is the most common nasal granuloma diagnosed clinically and pathologically. Although it mainly affects the anterior part of the nose, it is not uncommon to find cases with extensive lesions that extend to occupy the entire nasal cavity, and also to the sinuses and the orbit. Active rhinoscleroma is usually treated medically, and surgical intervention is carried out in the fibrotic stage. Theory The aim of this study was to determine the role of CO2 laser in the management of extensive active rhinoscleroma. Materials and methods This is a prospective study that included 24 patients with extensive rhinoscleroma in the active phase, that is, patients had almost complete nasal obstruction with mouth breathing. Patients were divided into two groups: group A (12 cases), who were managed only with medical treatment, and group B (12 cases), who were managed with CO2 laser debulking, concurrently with medical treatment. Results Patients were followed up clinically for nasal blockage and histologically to assess the activity of the disease; group B showed earlier relief of nasal obstruction and needed less medical treatment to reach the inactive stage. Conclusion CO2 laser debulking is a good option in treating extensive rhinoscleroma, even in the active stage, as it provides rapid relief of nasal blockage and decreases the time needed for medical treatment, reducing the possible side effects of antibiotics.