International Journal of Otorhinolaryngology and Head and Neck Surgery | October-December 2017 | Vol 3 | Issue 4 Page 807 International Journal of Otorhinolaryngology and Head and Neck Surgery Sinha M et al. Int J Otorhinolaryngol Head Neck Surg. 2017 Oct;3(4):807-811 http://www.ijorl.com pISSN 2454-5929 | eISSN 2454-5937 Original Research Article Clinical and epidemiological profile of patients with nasal manifestations of granulomatous disorders in a rural tertiary care centre Mohit Sinha 1 , Narendra Hirani 1 *, Ajeet Kumar Khilnani 1 , Yash Dhamecha 2 , Jitendra Pareek 3 INTRODUCTION Most of the times granulomatous disorders have obvious manifestations; however, sometimes they are difficult to diagnose. A literature review reveals that patients with granulomatous diseases may be frequently incorrectly diagnosed and treated. 1 At present limited data is available on the clinical and epidemiological profile of ABSTRACT Background: Most of the times granulomatous disorders have obvious manifestations; however, sometimes they are difficult to diagnose. A literature review reveals that patients with granulomatous diseases may be frequently incorrectly diagnosed and treated. At present limited data is available on the clinical and epidemiological profile of such patients in rural India. As such rural setup lacks the expert services of rheumatologist and the patients are frequently inconsistent with diagnostic protocols despite best efforts of the clinicians. Methods: This is a prospective study conducted in a tertiary care centre at Bhuj, Gujarat, India between January 2016 and May 2017. Patients included in the study had multi systemic complaints along with nasal manifestations such as recurrent epistaxis, saddling, synechia or swelling over nose. These patients were subjected to detailed history taking including demographic profile. They underwent detailed ENT examination, biopsies, radiological and serological tests and were discussed at multidisciplinary review meetings which involved physicians, otorhinolaryngologists, dermatologist, ophthalmologist, pathologist and radiologist. Results: Of the 19 patients included in this study, 53% patients were females. 84% (16 patients) belonged to rural household and 68% (13 patients) belonged to lower socioeconomic status. 9 patients (47%) were diagnosed with tuberculosis while Wegener’s granulomatosis and leprosy accounted for 3 cases (16%) each. 2 patients each were diagnosed with Cutaneous Leishmaniasis and fungal granulomas respectively. The average period between onset of symptoms and final diagnosis was 8 months. However, it took an average of 4.75 days after patient arrived at our centre to reach a final diagnosis. Conclusions: Early diagnosis of granulomatous disorders requires a multidisciplinary approach. The role of ENT surgeons is obvious as many granulomatous disorders have nasal manifestations. A multidisciplinary approach helps cut short the time between onset of disease and diagnosis, thus benefitting the patients by reducing the hospital stay and visits as most of these illnesses require outpatient treatment. Keywords: Fungal granuloma, Granulomatous disorders, Leishmaniasis, Tuberculosis, Wegener’s granulomatosis 1 Department of ENT, 2 Department of Dermatology, 3 Department of Medicine, Gujarat Adani Institute of Medical Sciences, Bhuj, Gujarat, India Received: 21 June 2017 Revised: 04 July 2017 Accepted: 06 July 2017 *Correspondence: Dr. Narendra Hirani, E-mail: entdeptgaims@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20173150