CASE REPORT Journal of Evolution of Medical and Dental Sciences/ Volume 2/ Issue 37/ September 16, 2013 Page 7135 LARYNGEAL RHINOSPORIDIOSIS – AN UNUSUAL CAUSE OF HOARSENESS Probal Chatterji 1 , Samrat Sandip Bose 2 HOW TO CITE THIS ARTICLE: Probal Chatterji, Samrat Sandip Bose. “Laryngeal rhinosporidiosis – an unusual cause of hoarseness”. Journal of Evolution of Medical and Dental Sciences 2013; Vol2, Issue 37, September 16; Page: 7135-7137. ABSTRACT: Rhinosporidiosis is a chronic infection caused by an organism called Rhinosporidium seeberi. It primarily affects the mucous membrane of the nose & nasopharynx. Involvement of other mucosal surfaces in the body has been reported but are extremely rare in occurrence. We are presenting a rare case of laryngeal rhinosporidiosis in a 36 year old male who presented with hoarseness of voice and progressive respiratory distress. He had previous history of multiple surgeries for nasal rhinosporidiosis. INTRODUCTION: A study was performed in our department from June 2009 to May 2011 to enumerate the various benign causes of hoarseness of voice. Among a total of 48 cases that were selected, we have come across a rare case of laryngeal rhinosporidiosis that we present below. Rhinosporidiosis is a chronic infection caused by an organism called Rhinosporidiosis seeberi which is mostly endemic in parts of India & Sri Lanka 1 . There has been a long standing confusion regarding the classification of the causative organism. Seeber in 1900 described it as a protozoa 2 but a couple of decades later it was designated as a fungus 3 . As recently as 1992, the disease has been described as a metabolic defect leading to the accumulation of lysosomal bodies loaded with indigestible residues 4 . Whatever the etiology, this condition predominantly affects the mucous membrane of the nose and nasopharynx and presents as multiple reddish polypoidal “strawberry-like” masses which are friable and bleed to touch 5 . Extranasal manifestation of rhinosporidiosis is exceedingly rare 6 . We are reporting a case of a 36 year old male with laryngeal rhinosporidiosis who presented with hoarseness of voice and progressive respiratory distress. CASE REPORT: A 36 year old male presented in the OPD with the chief complaint of progressive hoarseness of voice for the past one year. There was also an associated gradually worsening respiratory distress for last 4 months. He was a farmer by profession with no history of use of tobacco & alcohol. On enquiry, he produced records of two surgeries in the past for nasal rhinosporidiosis done elsewhere. On examination, there was slight degree of stridor at rest. The nasal airway was patent. Oropharynx was normal. On indirect laryngoscopy, multiple reddish polypoidal masses were seen arising from the ary-epiglottic folds and upper surface of both vocal cords with evidence of partial airway obstruction. He was counselled regarding the urgent need for surgery and advised routine pre-operative investigations, all of which were within the normal range. Finally after taking consent, he was admitted for microlaryngoscopy under general anesthesia after one week. Anesthesia was administered using a 6.5 mm cuffed endotracheal tube which was not only easy to negotiate but also allowed more space for the surgery. All the polypoidal material was removed as far as possible to obtain an adequate airway. Local bleeding was controlled using ribbon gauze packing. The obtained material was sent for histo-pathological examination.