Recurrent Lacrimal Sac Rhinosporidiosis Involving the Periocular Subcutaneous Tissues, Nasolacrimal Duct and Nasopharynx

Rogers, Simon; Waring, Dale; Martin, Peter A.

doi:10.3109/01676830.2012.700548

Cited by 4 publications

(7 citation statements)

References 9 publications

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“…Surgical removal of the lesion is the treatment of choice for oculosporidiosis, and it is recommended to use the adjunctive dapsone therapy to prevent sporangia maturation and promote stroma fibrosis [6, 13, 17]. Ocular recurrences are typically rare, with 1% rate for the conjunctiva, and between 2 and 40% for the lacrimal sac [26, 27, 32]. The causes: are incomplete excision of the lesion and spreading of endospores to the adjacent sites during a surgical procedure [14, 33].…”

Section: Discussionmentioning

confidence: 99%

“…The differential diagnosis includes mainly papilloma and pyogenic granuloma, which are treated with surgical excision of the lesion and cauterization of its base [13, 23, 24]. In association with surgery, dapsone is used to prevent the maturation of sporangia and promote fibrosis [25, 26]. The definitive diagnosis is obtained by histopathological examination, with demonstration of a fibrous stroma with several thick-walled sporangia at different stages of maturation and containing numerous endospores [24, 27, 28].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of diagnosed cases of eye rhinosporidiosis in a public hospital of Maranhão, Northeast Brazil

et al. 2019

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BackgroundOculosporidiosis (ocular rhinosporidiosis) accounts for 15% of cases of rhinosporidiosis, which is a chronic granulomatous disease and is endemic in India and Sri Lanka. In Brazil, the climatic and hydrographic similarities to these endemic areas and the presence of riverside populations contributes to an increase in the incidence of rhinosporidiosis particularly in the State of Maranhão. This study, therefore, aimed to identify the number of diagnosed cases of oculosporidiosis and describe its the clinical epidemiology, laboratory, histopathology, and therapeutic characteristics.MethodsThe study is descriptive, observational, and cross-sectional, and reports the prevalence and clinical epidemiological characteristics of oculosporidiosis in the State of Maranhão, Brazil. A retrospective analysis of the paper and electronic records for a period from 1999 to 2017 was conducted in the University Hospital of Federal University of Maranhão (HU-UFMA), located in the northeastern region of Brazil.ResultsThirty patients were diagnosed with rhinosporidiosis, eight of them had oculosporidiosis and seven of these met the criteria to be included in the study. Of the cases (23.3% of all 30), five were men (71.4%) and two women (28.5%), with an average age of 16.4 ± 15.6 years. In terms of race, four patients (57.1%) declared themselves white and three (42.9%) as brown. The north of the state, the mesoregion, had the most diagnosed cases accounting for 57.1% of the total. Left eye was the most affected site, reported in six patients (85.7%), while the conjunctiva was affected in all patients. Rhinosporidiosis and papilloma were the predominant diagnostic hypotheses (28.5 and 28.5%, respectively), followed by chronic scleritis, granuloma, and chalazion (14.25, 14.25, and 14.25%, respectively). All these cases were treated with lesion excision, and only two patients (28.5%) progressed with recurrence.ConclusionIt was verified that there was a male predominance, with only one eye reported as an infected site, with no bilateral involvement. The younger age group (between 1 and 2 years of age) was more affected by oculosporidiosis, and histopathological examination was necessary for a conclusive diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of diagnosed cases of eye rhinosporidiosis in a public hospital of Maranhão, Northeast Brazil

et al. 2019

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“…The current study presents a review of 31 studies published in the literature (Table 1). Most of the cases presented with swelling in the medial canthal area extending along the infraorbital margin [1], [2], [3], [7], [17], [14], [21], [9], [10], [11], [24], [25], [26], [27], [28], [29], [30], [31], [32], [33]. The swelling was fluctuant[1], [16] and boggy[7], [9], [33] and felt like a bag of worms 24 .…”

Section: Discussionmentioning

confidence: 99%

“…The swelling was fluctuant[1], [16] and boggy[7], [9], [33] and felt like a bag of worms 24 . It was painless in most of the studies,[1], [2], [9], [10], [15], [16], [18], [26], [34], [5], [6], [7] while some of them reported tenderness over the swelling [21], [22], [31]…”

Section: Discussionmentioning

confidence: 99%

“…Expanded NLD had displaced the IT medially.Sac wall was incised, pink vascularised, polypoidal growth was seen, sac was sutured, DCT done. Extension of growth in nasopharynx removed en bloc with the sac.NIL6 monthsdapsone givenNMDelhi (patient's native place not mentioned (India)16Rogers et al 26 20121Swelling left inner canthus.Watery discharge from noseNMPresentLSDacryocystogram showed passage of dye but significant constriction of the nasolacrimal duct.External DCR doneRecurrence noted10yrsNot givenNMSydney (Patient origin (Bangladesh)17Satya narayana 3 20093Non-compressible boggy swelling of the lacrimal sacNMNMNMLS with skin infiltration as was evident from skin ulceration on pressure with discharge of thick mucous secretion containing spores.Not doneExcision cautery, details not knownnot mentionedNMNMNMMadras (India)18Ghosh et al 28 20081Fluctuant swelling in medial canthus area with epiphora and purulent discharge from eye.Mucoid secretion from medial canthusNMPurulent discharge from the left eyeLSNot doneDCTNMNMNMNMKolkata (India)19Varshney et al 35 20081Right facial swelling, nasal obstruction and intermittent epiphora.NMBlockedwateringLS, Nose& oropharynxCystic fluid air filled lacrimal sac with irregular filling defect, no bony erosion. LS diverticulumLateral rhinotomy with sac excisionNil3 monthsNMNMDehradun (India)20Ghorpade et al 29 20071Gradually progressive, painful swelling under right eye for 8 months with scanty bloody nasal discharge.NMNMNMSmall nasal mass with extension in LS & NLDNot doneThe mass was reached through an incision in the right naso-optic sulcus.…”

Section: Introductionmentioning

confidence: 99%

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Lacrimal sac rhinosporidiosis: case report and review of literature with a new grading system to optimize treatment

Gupta

Singla

Pradhan

et al. 2019

Saudi Journal of Ophthalmology

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Rhinosporidiosis is a chronic granulomatous disease affecting the mucous membrane primarily and is caused by Rhinosporidium seeberi, an aquatic protistan parasite. The nose is the most common site of involvement and is seen in 83.3% cases, followed by ocular involvement in 11.2% cases and other sites like larynx, trachea and bronchus in 5.5% cases. In various oculosporidiosis case series, lacrimal drainage system involvement was seen to vary from 14.3% to 59.6% cases. Isolated lacrimal sac involvement in rhinosporidiosis was found in 45.8% (72 out of 157) cases of the lacrimal drainage system in a review of 31 studies.A variety of surgical procedures have been used to treat rhinosporidiosis of lacrimal sac like dacryocystorhinostomy, Dacryocystectomy, lateral rhinotomy and local lesion excision with a success rate varying from 28.5% to 92.3%. This wide variation in the success rate was due to the fact that a uniform surgical procedure was performed in all the cases of a particular series irrespective of the extent of disease.Grading the lacrimal sac rhinosporidiosis to decide the extent of surgical excision may help achieve better results. We present a grading system based on our own experience in a case of extensive rhinospodiosis of lacrimal sac and review of 31 studies published in the literature.A 24-year-old male from Nepal presented with the complaints of watering from his right eye of 13 years duration, swelling in the right medial canthal area with an extension to the inferior part of the orbit for 12 years and nasal blockage for 1.5 years. The patient had a history of previous intervention in which biopsy was taken from the nose and sent for histopathology that confirmed rhinosporidiosis. An extended intranasal endoscopic dacryocystectomy was done along with debridement and coblation of the lesion over the septum and nasopharynx. Intraoperatively a large rhinosporidiosis mass was seen filling the sac and was removed in toto along with the sac and nasolacrimal duct. Recurrence of a tiny lesion after 6 months in our case despite wide excision with the drilling of bony nasolacrimal duct and coblation, made us review the literature.

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Endoscopic Dacryocystorhinostomy in Chronic Granulomatous Lesions of the Lacrimal Drainage System

Gupta

2020

Endoscopic Dacryocystorhinostomy

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Recurrent Lacrimal Sac Rhinosporidiosis Involving the Periocular Subcutaneous Tissues, Nasolacrimal Duct and Nasopharynx

Cited by 4 publications

References 9 publications

Evaluation of diagnosed cases of eye rhinosporidiosis in a public hospital of Maranhão, Northeast Brazil

Evaluation of diagnosed cases of eye rhinosporidiosis in a public hospital of Maranhão, Northeast Brazil

Lacrimal sac rhinosporidiosis: case report and review of literature with a new grading system to optimize treatment

Endoscopic Dacryocystorhinostomy in Chronic Granulomatous Lesions of the Lacrimal Drainage System

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