‘Nasal flossing’: A case report of nasopharyngeal stenosis due to severe erosive lichen planus and a novel therapeutic intervention

Abstract

HighlightsAn unusual case of nasopharyngeal stenosis following severe erosive oral lichen planus is described.Initial surgical management was complicated by recurrent nasopharyngeal stenosis due to the intense underlying inflammatory disease process.‘Nasal flossing’ is described as a novel technique that can be used as an adjunct to prevent recurrence of nasopharyngeal stenosis and has relevance to a broad range of oral and nose and throat physicians.

Oral lichen planus: a microbiologist point of view

“…According to the World Health Organization, the disease can be considered as a premalignant condition and is also associated with immunodeficiency diseases (Peacock et al 2017 ), but it only requires surgery, to prevent nasopharyngeal stenosis, in very severe erosive cases (Alastair et al 2019 ). Gupta and Jawanda estimated in 2015 that lichen planus affects 0.5 to 2.0% of the general population (only a fraction of it corresponds to OLP), it is most common in middle-aged females, and it may go undetected for long periods of time (Bornstein et al 2008 ).…”

“…Human hepatitis C (HCV) is a virus that infects between three and four million people every year; Morozov and Lagaye ( 2018 ) estimate that there are 120–130 million people infected worldwide, but the association between HCV and OLP remains controversial. In 2001 , Mega and colleagues carried out an immunohistochemical study of OLP, demonstrating a strong association of the disease with the hepatitis C virus, while in 2005 , Elston, in his publication entitled “New and Emerging Infectious Diseases,” included OLP in illnesses that could be associated with the human hepatitis C virus. Two publications in 2010 , authored by Zhou and colleagues and Mahboobi and co-workers, reported the prevalence of HCV in patients with OLP, while 2 years later, Nagao and Sata ( 2012 ) found a similar association in a retrospective study carried out in Japan.…”

Relation between grades of acquired nasopharyngeal stenosis and severity of obstructive sleep apnea symptoms

“…Nowadays, most NPS cases are commonly secondary to uvulopalatopharyngoplasty (UPPP), adenotonsillectomy, laser-assisted uvulopalatoplasty (LAUP), or radiotherapy for nasopharyngeal carcinoma [1,2]. However, some cases of NPS were reported after severe erosive oral lichen planus [3], secondary to extra-laryngeal tuberculosis [4], and without known etiology was reported [5]. NPS is graded as type I (mild) when the lateral aspects of the soft palate adhere to the posterior pharyngeal wall.…”