Novel Approach to Rhinosporidiosis

Abstract

Rhinosporidiosis is a chronic enigmatic disease affecting mainly the upper aerodigestive tract and is notorious for frequent recurrences as high as 70%. Higher incidences of recurrence are mainly due to nonendoscopic excision with resultant resi­ dual disease leading to seedling of the disease. Objectives: The aim of this study is to highlight the factors responsible for recurrence and to follow the clinical course to ensure against recurrence of rhinosporidiosis. External surgery in rhinosporidiosis should be avoided for the fear of implantation. With the advent of endoscopes and Lasers allow the surgeon to complete excision of the lesion with cauterization of the base. Materials and methods: A retrospective study of thirty two cases of rhinosporidiosis presented to us over a period of 10 years from 2002 to 2012. Out of which 14 cases presented to us for the first time and 18 cases were recurrent cases. The commonest age group of presentation was between 20 and 30 years in patients presenting for the first time and in recurrent cases the commonest age of presentation was between 50 and 60 years of age. Majority of patients were males with male to female ratio of 9:1. All patients underwent endoscopic excision, electro cautery was used in 30 patients and Laser was used in 2 patients. Results: Fourteen cases did not have any recurrence and in the 18 cases of recurrent cases three of them again had a recurrence where electro cautery was used to cauterize the base. Conclusion: Endoscopic excision of rhinosporidiosis has a better result over nonendoscopic approaches with lesser recurrence rate. Our results show that use of endoscopes in patients who presented for the first time have a better results as the mucosa of recurrence patients have already been insulted due to previous surgeries.