Lepra nasal: impacto de la multiterapia en la morfología y la fisiología nasal

Introducción: El protocolo de terapia combinada ha permitido que los enfermos de lepra tratados según esta estrategia alcancen una curación sin secuelas neurotróficas ni deformidades. Objetivos: Determinar el impacto de la multiterapia en el desarrollo de las alteraciones del esqueleto óseo cartilaginoso y en la función respiratoria nasal. Pacientes y método: Estudiamos a 84 sujetos: 38 pacientes tratados con monoterapia, 22 pacientes tratados con multiterapia y 24 sujetos control. Exploramos la morfología nasal mediante rinoscopia anterior y la función respiratoria nasal mediante rinomanometría anterior activa. En el análisis estadístico se ha utilizado el test ANOVA de un factor. Resultados: En el grupo de monoterapia observamos una reabsorción osteocartilaginosa de las estructuras nasales y un aumento de las resistencias nasales. Los pacientes que recibieron multiterapia no presentaron cambios morfológicos significativos y la función respiratoria nasal se mantuvo dentro de la normalidad. Conclusiones: La terapia combinada es eficaz porque previene la aparición de deformidades nasales y la insuficiencia respiratoria nasal.

Introduction: The multi-drug therapy protocol has allowed leprosy patients following this strategy to achieve complete recovery without developing neurotrophic sequelae or deformities. Objectives: To assess the impact of multi-drug therapy on the development of nasal deformities and nasal airway patency. Patients and method: In an overall group of 84 patients studied, 38 were treated with a therapy based on a single drug and 22 were treated with multi-drug while 24 subjects formed a control group. Nose morphology was determined by anterior rhinoscopy. Nasal patency and flow resistances were measured by anterior rhinomanometry. The results were compared by using the Anova test for a single variable. Results: The nasal structures in the group with therapy based on a single drug underwent resorption of bone and cartilage in the structures of the nose and increased flow resistance. In the group receiving the multi-drug protocol, there were no significant morphological alterations and nasal patency and flow resistance remained within normal levels. Conclusions: The multi-drug therapy is effective in preventing the development of nasal deformities and maintains normal nasal airflow.