Changes in the pattern of rhinoscleroma in Egypt: updated experience.

OBJECTIVE: This study aimed to record recent changes in the incidence and clinical and histopathological patterns of rhinoscleroma in the middle of Nile Delta in Egypt. METHOD: Twenty-eight patients with rhinoscleroma were included in this study. Patients who were attending the Department of Otolaryngology at Tanta University Hospitals from January 2014 to January 2019 were included. Cases were diagnosed by clinical, bacteriological and histopathological data. Nasal biopsies were taken for histopathological and electron microscopy studies. All patients received a twelve-week course of 500 mg ciprofloxacin tablets twice daily. RESULTS: The rate of rhinoscleroma was shown to be decreasing compared with previous studies. In this study, the disease mainly affected the nose without involvement of the palate, lips, Eustachian tube or bronchi. Histopathological and electron microscopy analyses showed that most cases were in the atrophic and fibrotic stages rather than the granulomatous stage of disease. CONCLUSION: The incidence of rhinoscleroma in Egypt is decreasing and its clinical and histopathological patterns are changing to less advanced forms. This may be explained by the improvement in socioeconomic conditions and methods of treatment.

Ethmoidal scleroma: endoscopic diagnosis and treatment.

Twenty patients with medically treated rhinoscleroma and residual ethmoidal manifestations were examined using CT scanning. Cases with positive radiological data of the ethmoids underwent diagnostic and therapeutic nasal endoscopy. It has been found that ethmoidal scleroma is not as rare a condition as was previously thought. The diagnostic and therapeutic value of nasal endoscopy in ethmoidal scleroma is discussed.

Radiological and endoscopic study of the maxillary sinus in primary atrophic rhinitis.

The maxillary sinuses of 40 patients suffering from primary atrophic rhinitis (ozaena) were studied radiologically, antroscopically and histopathologically. Sixty per cent of the patients showed thick bony walls and a small cavity of the maxillary sinus on X-ray and on antroscopy. On the other hand, 25 per cent of the cases revealed signs of infection including mucopurulent secretion on antroscopy associated with corresponding histopathological changes. It is concluded that poor pneumatization of the antrum plays a more important role in the pathogenesis of ozaena than infection.

The effect of rifampicin on rhinoscleroma: an electron microscopic study.

Twenty-five cases suffering from rhinoscleroma were divided into two groups. The first group consisted of 15 patients treated with rifampicin systemically. The other group consisted of 10 patients treated locally with rifampicin in the form of ointment. Electron microscopic study of the pathological changes in the lesions showed that rifampicin is highly effective both systemically and locally in the treatment of rhinoscleroma.

Role of endoscopy in diagnosing scleroma in its uncommon sites.

Eighty cases suffering from rhinoscleroma were studied. Suspected cases were examined by sinoscopy, nasopharyngoscopy and bronchoscopy for detection of secondary involvement in these sites. Antroscleroma, salpingoscleroma and tracheo-bronchoscleroma have been found in a relatively high percentage of cases. The role of endoscopy in early diagnosis, initial symptomatic treatment and follow-up cases is discussed.

Local rifampicin in treatment of rhinoscleroma.

Many antibiotics, chemotherapeutic agents and other chemicals have been tried in the treatment of scleroma without much success (Toppozada et al., 1967). The most popular of these drugs are streptomycin and aureomycin (Botros et al., 1954; Zwiefach, 1955; El-Mofty, 1962), terramycin and chloromycetin (Hoover and King, 1953) and ampicillin, septrin and vibramycin (Ssali, 1975). El-Mofty and Attia (1957) attributed considerable value to the use of 20 per cent aureomycin ointment locally in treating the disease. Nigonol in the form of a local injection was tried by Toppozada et al. (1967) and they claimed good results. Shaer et al. (1981) reported that local application of 2 per cent acriflavine solution over an eight-week period was an effective and safe remedy for rhinoscleroma. Rifampicin has been used systemically with success as a new antibiotic for the treatment of scleroma (Riad, 1982). The aim of the present study was to evaluate the response of rhinoscleroma to local medication with rifampicin.