title: Airway scleromas and their extensions.
abstract: BACKGROUND
  Scleroma is a rare, chronic, granulomatous infectious disease of the respiratory tract mucosa which begins in the nose and spreads to the respiratory tract and adjoining structures. We report on the extensions and the management of 134 cases of scleroma in the Highlands region of Papua New Guinea.
  
  
  METHODS
  The charts and treatment records of 134 scleroma cases were retrospectively reviewed from 1995 to 2013. The staging, extensions, treatment and results of treatment were reviewed and analysed.
  
  
  RESULTS
  Of the 134 cases, 72 (53.7%) were females and the age ranged from 6 to 65 years. The disease was confined to the nose and nasopharynx in 71 (53.0%) cases. Extension of the disease from the nose to the Eustachian tube occurred in nine (6.7%) cases and into the middle ear in four (3.0%) cases. Further extensions to the larynx and trachea were seen in 17 (12.7%) cases each and the bronchus in three (2.2%) cases. Primary laryngoscleroma without involvement of the nose and nasopharyngeal stenosis without laryngeal involvement were managed in 11 (8.2%) and nine (6.7%) cases respectively. Others cases treated were ethmoid scleroma with proptosis and scleroma involving the upper lip in one (0.75%) case each. Ninety-nine (74.9%) patients were treated medically while 35 (26.1%) patients required surgery. Cure were achieved in 83 (61.9%) cases treated medically and 26 (19.4%) had successful surgical outcome.
  
  
  CONCLUSIONS
  Scleroma begins in the nose and when not arrested, extends causing obstruction to the airway and cosmetic deformity which requires surgical intervention.
authors.affiliation: Department of Ear, Nose and Throat, Port Moresby General Hospital, Boroko, Papua New Guinea.
authors.forename: Charles P
authors.initials: CP
authors.lastname: Molumi
authors.affiliation: Department of Ear, Nose and Throat, Port Moresby General Hospital, Boroko, Papua New Guinea.|School of Medicine and Health Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.
authors.forename: Siba P
authors.initials: SP
authors.lastname: Dubey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D007830:Larynx / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009305:Nasopharynx / Q000000981:diagnostic imaging*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D012189:Retrospective Studies; D012226:Rhinoscleroma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: extensions; nasopharyngeal stenosis; scleroma; surgical treatment