Rhinosclerosis
Introduction
Introduction to nasal induration Rhinoscleroma, also known as scleroma, is a low-infectious chronic inflammatory granulomatous disease caused by Rhizoctonia solani. Damage begins with the nose and invades the upper respiratory tract to form a hard granulomatous inflammatory mass that can cause deformity or obstruction. basic knowledge The proportion of illness: 0.02% Susceptible people: no specific population Mode of infection: non-infectious Complications: nosebleeds, olfactory disorders
Cause
Causes of nasal induration
(1) Causes of the disease
The pathogen is klebsiella rhinoscleromatis, also known as Frisch bacillus, Gram-negative, short rod-shaped, with a gelatinous capsule, no movement, infection mode and route have not been determined, but many have long-term contact with patients, may also The nutritional status of the body is related to immunity and environmental factors, and it is often regional. It is more common in China's Jiaodong area.
(two) pathogenesis
Nasal bacillus damage begins with the nose and invades the upper respiratory tract to form a hard granulomatous inflammatory mass that can cause deformity or obstruction.
Prevention
Nasal induration prevention
The early manifestations of this disease are not typical. In case of suspicious patients, nasal secretion test or bacterial culture should be done in time to confirm the diagnosis, pay attention to personal hygiene and avoid sharing sanitary equipment to prevent transmission. In recent years, we have tried to use 5% berberine droplet nose or 20% of the compound droplet nasal treatment, the disease is quickly controlled, and a series of blood circulation disorders can be caused by the infection of the bacillus sinus, resulting in tissue degeneration, and then with the treatment of blood stasis, softening and stasis of traditional Chinese medicine treatment, obtained Satisfactory effect.
Complication
Complications of nasal induration Complications, nosebleeds, olfactory disorders
Scar contracture can lead to facial damage, severe respiratory obstruction can cause difficulty in breathing, lesions involving the bronchi can cause suffocation and death, individual cases of osteolysis occur around the lesion, prone to secondary infection.
Symptom
Symptoms of nasal induration Symptoms Dry throat and burning sensation Osteolysis olfactory disorders Nasal bleeding Dyspnea
The onset usually starts from the nose, the disease progresses slowly, there is no systemic symptoms, the general health condition is not affected, and the disease development process can be divided into three phases:
Rhinitis
The earliest manifestations of common cold, headache, poor breathing, nasal secretions are sticky pus, stench, nasal purulent formation, dry throat, nosebleeds, mucous membrane hypertrophy, nasal septum mucosa, symptoms like atrophic rhinitis .
2. Infiltration period ( granuloma )
When the symptoms of rhinitis begin to subside, there is infiltration and obstruction under the nasal septum, followed by the throat. There are many dark purple-red nodules under the mucosa. The size of the peas can be fused to form a mass and adhere to the underlying tissue. The patient may have a tone change. , soft numbness, respiratory disorders, smell, loss of taste, etc.
3. Nodular stage (scarring period)
The condition continues to develop and expand, the granulation tissue is fibrotic, and hard scars are formed, the feeling is completely lost, the condition is further developed, the nostrils are completely blocked, forming a permanent stenosis, and the scar contracture causes the face to be destroyed. It looks like a hippo, a rhinoceros, and a severe obstruction of the respiratory tract can cause breathing. Difficulties, lesions involving the bronchi can cause suffocation and death, and individual cases develop osteolysis around the lesion.
The diagnosis was based on characteristic clinical symptoms, specific histopathological changes, and the pathogen was found to be positive for N. oxysporum and complement fixation test.
Examine
Nasal induration
The diagnosis is mainly combined with pathological examination, bacterial culture and serum complement fixation test, as well as clinically seen three-stage disease often present and regional characteristics, and suspicious cases need repeated material examination.
The N. oxysporum and complement fixation test were found to be positive at the lesion.
Histopathology: specific granuloma, can be found in a large number of plasma cells and highly specific Mikulicz cells, Russell corpuscle and Fricy bacillus, and a few spindle cells, collagen cell proliferation.
Mikuliez cells are large, vacuolated tissue cells with a diameter of 100-200 m. The cytoplasm is lightly stained, reticulated, with blurred boundaries, and the nucleus is on one side. The cytoplasm can be found in the cytoplasm.
Russell has a round or elliptical shape with a diameter of 20-40 m, which is twice that of normal plasma cells. It is bright red, uniform in staining, refractive, and non-nuclear. The corpuscle is formed in plasma cells and may be degenerative. product.
Diagnosis
Diagnosis and identification of nasal induration
The disease should be differentiated from atrophic rhinitis, syphilis, tuberculosis, leprosy, malignant granuloma, and tumors.
