LARYNGOTRACHEAL MANIFESTATIONS OF RHINOSCLEROMA

Rhinoscleroma is a rare, chronic granulomatous disease of infective ca usation. It usually begins in the nose and may progress to involve the larynx and trachea and cause dysphonia, strider, and airway obstructi on. Early rhinoscleroma is usually successfully treated with oral tetr acycline, yet laryngotracheal disease may require operative interventi on. The disease is rare in the United States, but with an increase in immigration from endemic areas, otolaryngologists should be familiar w ith the management of this rare disease. Current literature contains o nly a few reports describing the manifestations of this disease, mostl y in the form of case studies. This study is a retrospective review of our institutional experience with the management of 22 patients with rhinoscleroma, 13 of whom had laryngotracheal involvement. The focus o f this report is on the clinical manifestations of laryngotracheal scl eroma. All of the patients were treated with long-term antibiotics. Ni ne patients underwent endoscopy with or without dilation and laser exc ision. Three patients required emergency tracheostomy, all of whom wer e ultimately decannulated without any sequelae. A rational approach to management of this unusual disease is provided.