Publication:

A study of ENT symptoms in leprosy patients at a leprosy rehabilitation centre in Hyderabad, Telangana, India

Background Hansen’s disease (leprosy) remains endemic in India. Otorhinolaryngologic (ENT) involvement, particularly of the nasal mucosa, may occur early but is often overlooked. Early recognition is vital for timely treatment and prevention of irreversible deformities. The objective was to describe the spectrum and frequency of ENT manifestations among multibacillary leprosy patients at a rehabilitation center in Hyderabad, India.

Methods A cross-sectional observational study was conducted at Sivananda Rehabilitation Home from September 6-25, 2025. Forty-nine confirmed multibacillary patients (ages 12-70) underwent structured ENT evaluation, including anterior rhinoscopy, otoscopy, and oropharyngeal examination. For disease-type and bacteriological index (BI) correlations, an analytic cohort of 42 patients was used.

Results In the analytic cohort (n=42), disease distribution was lepromatous (47.6%), borderline lepromatous (40.5%), and mid-borderline (11.9%). Overall, 16/49 (32.7%) reported nasal symptoms, with epistaxis being most common (62.5%). Clinical examination revealed nasal abnormalities in 28/49 (57.1%); turbinate atrophy was most frequent (36.7%), followed by hypertrophy (12.2%) and septal perforation (8.2%). Notably, 75% of patients with septal perforation had a BI>4. No participant reported ear or throat symptoms, though incidental otoscopic findings occurred in 12.2%.

Conclusions ENT involvement is common in multibacillary leprosy, predominantly affecting the nose. Objective nasal findings significantly outpace reported symptoms. Routine ENT evaluation, specifically focused nasal examination, should be incorporated into standard leprosy assessments to support early recognition and reduce complications.