RESUMO
The role of nasal infection in the transmission of leprosy has been extensively studied. Leprosy can affect the paranasal sinuses due to mucosal continuity and bacillaemia. This prospective study was performed on 25 untreated patients with lepromatous leprosy. 5 mm contiguous axial and coronal CT sections of paranasal sinuses, on soft tissue and bone windows, were obtained in all patients. Each sinus was examined for mucosal thickening, soft tissue densities and bony outlines. Representative biopsies were taken from ethmoid sinus to confirm the radiological diagnosis in 12 patients with multiple paranasal sinus involvement. Ethmoid aircells were involved in 20 patients (80%). Maxillary, frontal and sphenoid sinuses showed abnormalities in 12, four and three patients, respectively. The ethmoid biopsy showed involvement by lepromatous leprosy in seven of 12 patients (58.3%). Involvement of paranasal sinuses is common in lepromatous leprosy and is of considerable epidemiological significance.
Assuntos
Hanseníase Virchowiana/diagnóstico por imagem , Doenças dos Seios Paranasais/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Seio Etmoidal/diagnóstico por imagem , Feminino , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Pessoa de Meia-Idade , Septo Nasal/diagnóstico por imagem , Estudos ProspectivosRESUMO
The nasal mucosal involvement in lepromatous leprosy is well recognized. Currently interest has centred around the involvement of paranasal sinuses in leprosy. They act as a reservoir and constant source of reinfection to the nasal mucosa. In the present prospective study 25 untreated patients with multi-bacillary leprosy were included. Clinical examination, computed tomography (CT) scan of paranasal sinuses, ethmoid sinus endoscopy and biopsy were carried out in all patients, to investigate the involvement of the paranasal sinuses in leprosy. Ethmoid sinus involvement was noted in 20 patients on CT scan. Bilateral involvement was more common (65 per cent). Anterior ethmoids were more commonly affected (65 per cent). On ethmoid sinus endoscopy abnormal mucosa was noted in 17 patients (68 per cent). Ethmoid sinus biopsy was confirmative in 16 patients (64 per cent). Statistically significant correlation was found between CT findings, sinus endoscopy and sinus biopsy findings.
Assuntos
Seio Etmoidal/microbiologia , Hanseníase/microbiologia , Adolescente , Adulto , Idoso , Biópsia , Endoscopia , Seio Etmoidal/diagnóstico por imagem , Feminino , Humanos , Hanseníase/diagnóstico por imagem , Hanseníase Dimorfa/diagnóstico por imagem , Hanseníase Dimorfa/microbiologia , Hanseníase Virchowiana/diagnóstico por imagem , Hanseníase Virchowiana/microbiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Tomografia Computadorizada por Raios XRESUMO
Thirty patients of lepromatous leprosy have been studied by radiological investigation for affection of paranasal sinuses. It has been found that leprosy involves all groups of sinuses and maxillary antrum is found to be more commonly affected. Diffuse hypertrophy type of lesion is more commonly recorded in maxillary antrum, in x-ray of paranasal sinuses. The clinical significance and importance of extension of disease in the sinuses is discussed in the light of available literature.