Pharyngeal induration

Introduction

Introduction to pharyngeal induration Scleroma is a chronic progressive granulomatous lesion that usually occurs in the nose and slowly develops in the upper lip, nasopharynx, ankle, pharynx, larynx, trachea, sinus, and nasolacrimal duct. Invade the lymph nodes or transfer elsewhere. Because the nose has lesions accounted for more than 98%, the disease is also called induration or rhinoscleroma (rhinoscleroma), a small number of cases can be primary in the pharynx, larynx or trachea without involving the nose. Hard knot disease is a sporadic local epidemic that has been reported around the world. According to the statistical analysis of a large amount of data in the country, except for Taiwan and Tibet, the two provinces have their own diseases. Among them, Shandong Province has the highest incidence rate, accounting for 46% of the total. basic knowledge Sickness ratio: 0.001%-0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: tinnitus

Cause

Causes of pharyngeal sclerosis

Cause:

The disease is probably caused by the bacterium, which is also known as Frisch. In 1882, the first pathogen of the disease was found in the diseased tissue, the hard bacillus, but it often fails in the subsequent animal and human vaccination. There are also many scholars who are skeptical, have a long course of disease, have a long history of exposure, may be mildly contagious, and are related to personal nutritional status and immunity, as well as environmental health.

Prevention

Pharyngeal induration prevention

Generally, comprehensive treatment is adopted according to the condition, such as deformity in the scar stage, surgery can be performed to shape, and those with dyspnea for pharyngeal and laryngeal diseases should undergo tracheotomy and throat surgery to remove the diseased tissue. After treatment, such as The bacterium has been negative, and the biopsy has not seen the pathological changes of progressive induration, or the complement-binding reaction has turned negative, which can be considered as a cure.

Complication

Complications of pharyngeal induration Complications, tinnitus

Can cause functional dysfunction in the corresponding parts, such as tinnitus, ear nausea, heavy hearing, dry throat discomfort and dry cough, hoarseness and difficulty breathing.

Symptom

Symptoms of pharyngeal sclerosis common symptoms dry cough dyspnea nasal congestion ear purulent secretion tinnitus granuloma

Clinical diagnosis of typical cases is not difficult, according to the development of chronic progressive lesions, lesions, nodular stiffness and cartilage (pale, late purple, generally no ulcers and necrosis with scar formation, no local pain, third-stage disease Can be diagnosed at the same time, as well as local characteristics, biopsy can confirm the diagnosis. Bacterial culture: Hard bacilli may be found by grinding the atrophic phase of nasal secretions, induration or scar tissue into a suspension. Serum complement fixation test: Hard bacillus can produce antibodies in patient serum, so this test has great diagnostic value.

The pathological changes of induration can be divided into three stages, namely, catarrhal phase, induration stage and scar stage. Different pathological features appear at different stages, but the three can exist simultaneously or in transition form.

Depending on the location of the lesion, usually nasal congestion, nasal dryness and nasal discharge are common symptoms. The lesion invades the nasopharynx, eustachian tube, oropharynx, larynx, tracheobronchial, etc., which can cause dysfunction in the corresponding part, such as Tinnitus, ear nausea, heavy hearing, dry throat discomfort and dry cough, hoarseness and difficulty breathing, pharyngeal examination showed different manifestations in different stages of development of the lesion.

(1) catarrhal period (also known as atrophic period or diffuse period)

The early lesions of the nasal mucosa are mainly dry, hemorrhagic and suede adhesion, followed by atrophic changes, like atrophic rhinitis, but the special odor of odorless nose, the pharyngeal mucosa is dry, thin and shiny, adhered to the posterior pharyngeal wall A purulent discharge or molting.

(b) induration (also known as granuloma)

More in the nasal vestibule, septum and lower nail end and upper lip, there is a nodular mass, its color is slightly light, the surface mucosa is smooth, small blood vessels are dilated, the texture is hard, and the pharyngeal mucosa is scattered. The size varies, like a large needle tip, the bean is large or even into a small piece of nodular protuberance, the touch is hard, and the surface can cover the purulent sputum.

(3) Scar stage

Hyperplastic fibrosis forms scars, and various deformities such as anterior nasal stenosis, atresia, pharyngeal, laryngeal scarring or uvula disappear.

Examine

Examination of pharyngeal induration

Biopsy can confirm the diagnosis, bacterial culture: the nasal secretions, induration tissue or scar tissue in the atrophic period can be found in the suspension. It may find the hard bacillus, serum complement binding test: Hard bacillus can produce antibodies in the patient's serum, so this test is very large Diagnostic value.

Diagnosis

Diagnosis and diagnosis of pharyngeal induration

The disease is very similar to atrophic rhinitis and atrophic pharyngitis and atrophic laryngitis, but the mucosa is not extremely atrophy, no strange odor, scattered granular granulation or hard infiltration on the atrophic mucosa, it must be ruled out Syphilis, tuberculosis, lupus vulgaris, malignant granuloma, tumor, keloid and leprosy, it is not difficult to distinguish between induration and malignant tumors. Both diseases may exist at the same time. It is also believed that malignant tumors may occur on the basis of induration.

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