241 results on '"Allergic fungal sinusitis"'
Search Results
2. Add-on Dupilumab for AFRS as Postoperative Therapy (ADAPT) (ADAPT)
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Sanofi and Joshua M. Levy, Adjunct Professor
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- 2024
Catalog
3. Basilar artery infarction as a rare complication of allergic fungal rhinosinusitis: Case report and literature review.
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AlZahir, Batool, Al-Momen, Zahra, Al-Darwish, Ayat, Alsabaa, Sumayah, and Albaharna, Hussain
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ALLERGIC fungal sinusitis ,BASILAR artery ,SYMPTOMS ,PARANASAL sinuses ,NASAL polyps - Abstract
Background: Fungal rhinosinusitis is subdivided into two subtypes, invasive and noninvasive variants, with allergic fungal rhinosinusitis (AFRS) being the most prevalent noninvasive variant. The most common clinical features of AFRS are nasal polyposis, rhinorrhea, facial pressure, and periorbital edema. Objective: This study aimed to report a rare clinical presentation and serious complications of AFRS. Method and result: The patient was presented to the Otorhinolaryngology Department of Qatif Central Hospital, Eastern Region, Saudi Arabia. We reported a rare presentation of a patient diagnosed with untreated AFRS complicated by basilar artery thrombosis. The patient was urgently managed with endoscopic sinus surgery, postoperative antifungal, and local nasal steroids. Conclusion: Allergic fungal rhinosinusitis is a chronic disorder associated with significant morbidity that requires early diagnosis and management. The treatment protocol was based on surgical debridement of the paranasal sinuses from the fungal material and postoperative steroid therapy. Allergic fungal sinusitis with granuloma was more aggressive and needed to be treated cautiously by adding antifungal treatments. [ABSTRACT FROM AUTHOR] more...
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- 2024
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4. Sinonasal Risk Factors for Occurrence of Unilateral Versus Bilateral Allergic Fungal Rhinosinusitis .
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Al khater nosir sayed, Sinonasal risk factors for occurrence of unilateral versus bilateral allergic fungal rhinosinusitis
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- 2024
5. Dupilumab in Allergic Fungal Rhinosinusitis (AFRS) (LIBERTY-AFRS-AI)
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Regeneron Pharmaceuticals
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- 2024
6. A study to assess the efficacy of oral itraconazole as an add-on to steroids in allergic fungal rhinosinusitis in a tertiary care hospital.
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K. R., Mamatha, Sankar, Rajasree G., Varghese, George T., G., Puttamadaiah, and K., Suhas
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ITRACONAZOLE ,ALLERGIC fungal sinusitis ,TERTIARY care ,STEROID drugs ,ENDOSCOPIC surgery - Abstract
Background: Allergic fungal rhinosinusitis (AFRS) is a distinct type of chronic polypoid rhinosinusitis that affects atopic individuals. The incidence worldwide ranges from 5% to 10%, with geographic variation in epidemiology. It imposes a significant negative impact on quality of life, concomitantly generating socioeconomic losses. Failure to remove all sinus disease increases the likelihood of relapse; thus, the best outcome is achieved through coordinated medical-surgical care. The antifungal activity of itraconazole in addition to standard steroid therapy may provide greater relief to patients with AFRS following functional endoscopic sinus surgery (FESS) by decreasing the chances of recurrence and long-term use of steroids. Therefore, this study has been taken up. Aim and Objectives: The aims and objectives of the study are to evaluate the efficacy of oral itraconazole as an add-on to the standard steroid therapy in allergic fungal rhinosinusitis from baseline to 6 weeks. Materials and Methods: This study was conducted among 60 patients who underwent FESS and were administered medications postoperatively. The efficacy was measured by the sinonasal outcome test-20 score, the nasal endoscopic grade, and the Lund and Mackay score from baseline to 6 weeks. Continuous data were analyzed using the unpaired t-test, repeated measure analysis of variance, and paired t-test, whereas categorical data were analyzed using the Chi-square test. Results: Comparable efficacy was observed between the group treated with standard steroids alone and the group receiving a combination of standard steroids and itraconazole. No significant improvement was seen with oral itraconazole as an add-on therapy when compared with standard steroids at the end of 6 weeks. Conclusion: Oral itraconazole as an add-on therapy will reduce the chances of recurrence such as steroids, but in this study, there was no statistically significant reduction. The disease has a long natural course, and further follow-up is needed to establish the importance of itraconazole. [ABSTRACT FROM AUTHOR] more...
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- 2024
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7. Abducens nerve palsy secondary to allergic fungal sinusitis.
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Alsaleh, Majd A and Almomen, Ali A
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ALLERGIC fungal sinusitis , *NEUROLOGICAL disorders , *SALINE irrigation , *SALINE solutions , *PARANASAL sinuses - Abstract
Allergic fungal rhinosinusitis (AFRS) stands out as the predominant form of fungal sinusitis, primarily attributable to a hypersensitive response to fungal invasion. AFRS Characterized by symptoms of rhinosinusitis. The expanding mass in the disease leads to bony restructuring and implicating adjacent anatomical structures. AFRS may extend beyond the sinus cavities, leading to compression of nearby structures like the orbit, optic and abducens nerves which leads to many complications such as nerve palsies and proptosis. Diagnosis of AFRS typically necessitates radiographic assessment initially, with histopathological examination serving as the confirmatory modality. The management of AFRS typically entails a multifaceted approach integrating surgical intervention alongside medical therapy. This case report illustrates a distinctive manifestation of abducens nerve palsy secondary to allergic fungal sinusitis which had dramatic improvement and resolution of the diplopia after the Endoscopic sinus surgery. Steroids and nasal saline irrigation have been prescribed post operatively to prevent the recurrence. [ABSTRACT FROM AUTHOR] more...
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- 2024
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8. Eosinophilic mucus diseases.
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Arima, Misaki, Ito, Keisuke, Abe, Tomoe, Oguma, Tsuyoshi, Asano, Koichiro, Mukherjee, Manali, and Ueki, Shigeharu
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ALLERGIC fungal sinusitis , *MUCUS , *PULMONARY aspergillosis , *OTITIS media , *TISSUE remodeling , *POISONS , *KERATOCONJUNCTIVITIS - Abstract
Eosinophilic inflammation is primarily characterized by type 2 immune responses against parasitic organisms. In the contemporary human being especially in developed countries, eosinophilic inflammation is strongly associated with allergic/sterile inflammation, and constitutes an undesired immune reaction. This situation is in stark contrast to neutrophilic inflammation, which is indispensable for the host defense against bacterial infections. Among eosinophilic inflammatory disorders, massive accumulation of eosinophils within mucus is observed in certain cases, and is often linked to the distinctive clinical finding of mucus with high viscosity. Eosinophilic mucus is found in a variety of diseases, including chronic allergic keratoconjunctivitis, chronic rhinosinusitis encompassing allergic fungal sinusitis, eosinophilic otitis media, eosinophilic sialodochitis, allergic bronchopulmonary aspergillosis/mycosis, eosinophilic plastic bronchitis, and eosinophilic asthma. In these pathological conditions, chronic inflammation and tissue remodeling coupled with irreversible organ damage due to persistent adhesion of toxic substances and luminal obstruction may impose a significant burden on the body. Eosinophils aggregate in the hyperconcentrated mucus together with cell-derived crystals, macromolecules, and polymers, thereby affecting the biophysical properties of the mucus. This review focuses on the clinically significant challenges of mucus and discusses the consequences of activated eosinophils on the mucosal surface that impact mucus and persistent inflammation. [ABSTRACT FROM AUTHOR] more...
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- 2024
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9. Exploring Sociodemographic Factors in Allergic Fungal Rhinosinusitis in a Northern California Patient Population.
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Debbaneh, Peter, Singh, Priyanka, Swisher, Austin R., Wei, Julia C., and Liang, Jonathan
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ALLERGIC fungal sinusitis , *SOCIODEMOGRAPHIC factors , *DEMOGRAPHIC characteristics , *RACE , *BLACK people , *DERMATOPHAGOIDES pteronyssinus - Abstract
BACKGROUND: Allergic fungal rhinosinusitis (AFRS) is a subtype of chronic rhinosinusitis (CRS) that has previously been associated with younger age and Black patients. However, the role of demographic and socioeconomic factors in AFRS severity remains to be fully elucidated. OBJECTIVE: The objective of this study was to determine whether demographic and socioeconomic factors are associated with incidence of AFRS, as well as with disease severity in Northern California. METHODS: A retrospective cohort study was conducted of adult patients with AFRS and CRS from 2010 to 2019. AFRS was determined by the Bent and Kuhn criteria, and severity was assessed by radiographic evidence of cranioorbital invasion and other clinical parameters. Chi-square and t-test were used to assess demographic and socioeconomic differences between AFRS and CRS cohorts, and multivariable logistic regression was used to assess risk factors for severe AFRS. RESULTS: Black patients represented 26.2% (55/210 patients) of the AFRS group and 4.9% (842/17,300 patients) of the CRS group, with pairwise comparison of race/ethnicity categories showing that the AFRS group had significantly higher proportions of Black race/ethnicity compared with other race/ethnicities (p < 0.01). AFRS and CRS groups differed significantly by age, with mean ages of 48.7 and 51.0 years, respectively (p = 0.04). There were no significant differences in gender, Medicaid status, comorbidities, and socioeconomic status measures. Multivariate logistic regression showed that Black patients had higher odds of having severe AFRS (adjusted odds ratio = 2.29; 95% confidence interval: 1.18–4.45). CONCLUSION: AFRS has a unique predilection for Black patients, and severe disease is also more likely in this population. [ABSTRACT FROM AUTHOR] more...
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- 2024
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10. Pediatric Unilateral Chronic Sinusitis: Clinical and Radiological Patterns Compared to Adults.
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Sadek, Ahmed Adel, Mahmoud Nasr, Maisara Mohamed, Mohamed Badawi, Ahmed Ali, Esmaeel, Tamer El Zaeem, and Awad, Osama Galal
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ALLERGIC fungal sinusitis , *SINUSITIS , *RESPIRATORY infections , *ADULTS , *CHILD patients , *MAXILLARY sinus diseases - Abstract
Introduction: Upper respiratory tract infections and sinusitis are more prevalent in children than in adults. Unilateral sinusitis is not uncommon disease. Our aim was to analyze the disease characteristics in children with unilateral sinusitis and compare them with those of adults. Materials and Methods: This study included 124 patients with unilateral chronic sinusitis divided according to age into two groups: pediatric group =18 years (66 cases) and adult group >18 years (58 cases). The groups were compared in terms of demographic data, side, clinical manifestations and radiological findings. Results: In pediatric patients, the most common inflammatory pathology was antrochoanal polyps, followed by allergic fungal sinusitis. On the other hand, chronic sinusitis without nasal polyps is the most common in adults, followed by antrochoanal polyps. The mean duration of clinical manifestations before diagnosis in pediatric patients was significantly shorter than that in adults (P=0.001). The most common symptoms in both pediatric and adult patients were anterior nasal discharge and nasal obstruction. Proptosis was significantly higher in pediatric group than in adult group (P=0.015). On computed tomography (CT), the most commonly affected sinus in both pediatric and adult patients was the maxillary sinus followed by the anterior ethmoid sinus. Bone expansion, erosion and involvement of adjacent structures were significantly higher in pediatric patients (P=0.028, 0.027 respectively). Conclusion: Pediatric patients have a high incidence of antrochoanal polyps and allergic fungal sinusitis as unilateral inflammatory lesions. These lesions require surgical management. Inflammatory paranasal sinus lesions in pediatric patients have a shorter duration of clinical manifestations and a higher incidence of bone erosion and involvement of adjacent structures; therefore, early diagnosis and management prevent complications. [ABSTRACT FROM AUTHOR] more...
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- 2024
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11. Utilization of dupilumab in an immunocompromised patient with extensive allergic fungal rhinosinusitis unsuitable for surgical intervention: A case report
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Alotaibi, Naif H., Abaalkhail, Mashal, Almusa, Hala, Alshenaifi, Lama A., and Alomairin, Ahmed
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- 2025
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12. Role of Imaging in Complications of Sinusitis
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Mohamed Osama Mohamed, Resident of radiology at sohag university hospital
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- 2023
13. Biologic Therapies across Nasal Polyp Subtypes.
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Bolk, Kody G. and Wise, Sarah K.
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ALLERGIC fungal sinusitis , *BIOTHERAPY , *NASAL polyps , *RESPIRATORY therapy , *RESPIRATORY diseases , *SINUSITIS - Abstract
Chronic rhinosinusitis with nasal polyposis is a common inflammatory condition, with subtypes like aspirin-exacerbated respiratory disease, allergic fungal rhinosinusitis, and central compartment atopic disease sharing a common type 2 inflammatory pathway. Respiratory biologic therapies have been developed that target type 2 inflammation. In this article, we discuss the use of respiratory biologic therapies for nasal polyposis in general, as well as within the various subtypes of nasal polyps. Further, we discuss future roles of novel biologic therapies targeting type 2 inflammation in nasal polyposis. [ABSTRACT FROM AUTHOR] more...
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- 2024
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14. Prelacrimal Recess Approach in Unilateral Maxillary Sinus Lesions: What Is the Impact and Efficacy?
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Abdulla, Mohamed, Refaat, Osama, Alahmer, Mohamed, Yehia, Ayman, Abdelsalam, Hesham, Abdelaal, Khaled, and Shams Eldin, Mohamed
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MAXILLARY sinus ,MAXILLARY sinus diseases ,ALLERGIC fungal sinusitis ,ENDOSCOPIC surgery ,MAXILLARY sinus surgery ,LACRIMAL apparatus ,COMPUTED tomography - Abstract
Background and Objectives: Chronic sinusitis is a commonly encountered diagnosis for otorhinolaryngologists. The profound negative effect of rhinosinusitis on patients' quality of life is frequently overlooked, and surgical lines of treatment are numerous. The aim of the study was to assess the comparative efficacy of endoscopic middle meatal antrostomy with the endoscopic prelacrimal recess approach, combined with middle meatal antrostomy in the treatment of unilateral chronic maxillary sinus lesion. Materials and Methods: Thirty patients with unilateral chronic maxillary sinus lesions enrolled in the study at Alahsa hospital. Patients were divided into two groups: 15 treated through a middle meatal antrostomy and 15 treated via a combined middle meatal antrostomy and prelacrimal recess approach. Demographic and clinical information of the patients, including the medical history, CT scan findings, diagnosis, recurrence, and complications, were gathered and analyzed. Pre- and postoperative clinical findings were graded utilizing the Lund–Kennedy Endoscopic Scoring System. Results: The enrolled patients varied in age from 18 to 56, with 60% being male and 40% being female. Antrochoanal polyp, maxillary sinus mucocele, and unilateral allergic fungal sinusitis were among the pathological diagnoses. The follow-up period averaged 14.3 months. Following surgery, two patients in Group II encountered nasal discomfort, which included synechia and epiphora. The success rate for preserving a patient's disease-free condition was 86.7%. A statistically significant difference in disease-free incidence was observed among the patients in group II. In group I, recurrence was identified in 26.7% of the patients. The postoperative symptoms diminished considerably, and the VAS score was reduced substantially. In Group II patients, however, there was no significant difference in scarring. Clinically significant differences were observed in the mean total Lund–Kennedy Endoscopic scores when compared to their preoperative values. Conclusions: Achieving endoscopic access to the sinus's anterior, lateral, inferior, and inferomedial regions is facilitated by operating via the prelacrimal recess, which is the most advantageous approach. This approach facilitates rapid mucosal healing by maintaining the integrity of the nasolacrimal duct and mucosal covering. The specific pathology, surgical objectives, surgeon expertise, and equipment accessibility influence the choice of endoscopic surgical technique. [ABSTRACT FROM AUTHOR] more...
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- 2024
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15. Periantral fungal abscess after zygoma reduction: a case report.
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Keun Hyung Kim, Hoon Kim, Soo Yeon Lim, and In Chang Koh
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ABSCESS treatment , *ZYGOMA , *MYCOSES - Abstract
This case report describes our treatment of a persistent periantral abscess in a 35-year-old woman. The abscess developed following a zygoma-reduction surgery, during which a preexisting fungal ball had not been addressed. Our comprehensive treatment approach included functional endoscopic sinus surgery, fungal ball removal, abscess drainage, and debridement. Two weeks postoperatively, the patient's symptoms had resolved. A 6-month postoperative follow-up revealed no signs of recurrence or complications, and the patient reported satisfactory functional and aesthetic results. This case underscores the importance of thorough preoperative evaluations and raises awareness about the potential risks of untreated asymptomatic pathologies, which can potentially progress and lead to further complications. [ABSTRACT FROM AUTHOR] more...
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- 2023
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16. Anatomical Variations Associated With Maxillary Sinus Fungal Ball.
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Basurrah, Mohammed, Lee, Il Hwan, Kim, Do Hyun, Kim, Sung Won, and Kim, Soo Whan
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CONFIDENCE intervals , *MAXILLARY sinus , *ALLERGIC fungal sinusitis , *PATHOLOGICAL anatomy , *PERIODONTAL disease , *PARANASAL sinuses , *NASAL septum , *DESCRIPTIVE statistics , *SINUSITIS , *COMPUTED tomography , *ODDS ratio - Abstract
Objective: We investigated the anatomical and dental factors associated with unilateral maxillary sinus fungal ball (MSFB). Also, we evaluated the effect of combinations of those factors on the incidence of MSFB. Methods: Three hundred patients were divided into MSFB, normal, and chronic rhinosinusitis (CRS) groups. We reviewed paranasal computed tomography scans for the presence of deviated nasal septum, concha bullosa (CB), Haller cells, and various dental factors. Also, we measured the ethmoid infundibulum, maxillary natural ostium, and CB. Results: Maxillary sinus fungal ball showed a more significant association with CB compared to the other 2 groups (37%, P <.05). The MSFB group had a lower rate of Haller cells than the normal group (10% vs 22%, respectively; P <.05). Also, the MSFB group had a wider maxillary sinus ostium than the normal group (7.07 ± 1.8 vs 5.48 ± 1.3 mm; P <.01). Moreover, the combination of CB and Haller cells was significantly associated with a decreased rate of the fungal ball (P =.047, odds ratio = 0.694). The dental factors were more prevalent in the MSFB and CRS groups (73% and 75%, respectively) than in the normal group (32%, P <.001). Conclusions: Maxillary sinus fungal ball is significantly associated with CB, Haller cells, an increased maxillary sinus ostium size, and dental factors. [ABSTRACT FROM AUTHOR] more...
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- 2023
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17. Allergic fungal rhinosinusitis and eosinophilic mucin chronic rhinosinusitis: Differential diagnostic criteria. A two-center comparative study following STROBE methodology.
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Dubois, A., Simon, F., Alanio, A., Guillonnet, A., Kaci, R., Herman, P., Lecanu, J.-B., and Verillaud, B.
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ALLERGIC fungal sinusitis ,MUCINS ,SINUSITIS ,NASAL polyps ,FISHER exact test ,STROBOSCOPES ,DERMATOPHAGOIDES pteronyssinus ,RHINOVIRUSES - Abstract
Allergic fungal rhinosinusitis (AFRS) and eosinophilic mucin chronic rhinosinusitis (EMRS) are two forms of chronic sinusitis distinguished by the presence (AFRS) or absence (EMRS) of fungal elements in sinus mucin. Detection of the fungal elements, however, is complex and it is difficult to say whether EMRS is in fact an entity distinct from AFRS. The aim of the present study, based on a retrospective series of AFRS and EMRS, was to identify the specific clinical and radiological elements distinguishing between the two. A 2-center retrospective observational study following STROBE guidelines included patients managed for AFRS or EMRS between 2009 and 2022. Clinical, mycological, pathologic and radiological data were collected. Type of treatment and disease progression were also analyzed. Intergroup comparison used Student's test for mean values of quantitative variables, with calculation of P -values, and Pearson's Chi
2 test or Fisher's exact test for categoric variables, with calculation of relative risk and 95% confidence intervals. The AFRS group comprised 41 patients and the EMRS group 34. Demographic data were comparable between groups. EMRS showed a higher rate of asthma (79.4 vs. 31.4%; P < 0.001), more severe nasal symptomatology (rhinorrhea, P = 0.01; nasal obstruction, P = 0.001), and more frequent bilateral involvement (85.3 vs. 58.5%; P = 0.021). AFRS showed more frequent complications (19 vs. 0%; P = 0.006). Radiologically, mucin accumulation was greater in AFRS, filling the sinus in 84.2% of cases, versus 26.3% (P < 0.001), with more frequent sinus wall erosion (19 vs. 5.8%; P = 0.073). The recurrence rate was higher in EMRS: 38.2 vs.21.9% (P = 0.087). The present retrospective study found a difference in clinical and radiological presentation between AFRS and EMRS, with EMRS more resembling the presentation of severe nasal polyposis. [ABSTRACT FROM AUTHOR] more...- Published
- 2023
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18. Allergic fungal rhinosinusitis: What we can learn from allergic bronchopulmonary mycosis.
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Nakayama, Tsuguhisa, Miyata, Jun, Inoue, Natsuki, and Ueki, Shigeharu
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ALLERGIC fungal sinusitis , *MYCOSES , *IMMUNOGLOBULIN E , *ASTHMA , *EOSINOPHIL disorders , *PARACOCCIDIOIDOMYCOSIS , *NASAL polyps - Abstract
Allergic fungal rhinosinusitis (AFRS) and allergic bronchopulmonary mycosis (ABPM) are inflammatory disorders of the respiratory tract resulting from type 1 and 3 hypersensitivity reactions against fungi. The hallmark features of both diseases are eosinophil infiltration into the airway mucosa caused by localized type 2 inflammation and concomitant viscid secretions in the airways. Eosinophilic mucin-induced compression of adjacent anatomic structures leads to bone erosion and central bronchiectasis in the upper and lower respiratory tracts, respectively. Although these diseases share common features in their pathogenesis, they also exhibit notable differences. Epidemiologic findings are diverse, with AFRS typically presenting at a younger age, exhibiting less complicated bronchial asthma, and displaying lower total immunoglobulin E levels in laboratory findings compared with ABPM. Furthermore, despite their similar pathogenesis, the rarity of sinio-bronchial allergic mycosis in both AFRS and ABPM underscores the distinctions between these two diseases. This review aims to clarify the similarities and differences in the pathogenesis of AFRS and ABPM to determine what can be learned about AFRS from ABPM, where more is known. [ABSTRACT FROM AUTHOR] more...
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- 2023
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19. Role of interleukin-5 in allergic fungal sinusitis: deeper insight
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Hassan Alaa Mohamed El Ebiary, Amr Gouda Shafik, Mohammed Mohammed Kamar El Sharnoby, Lobna Sadek Shash, Amr Hamed Mohamed Hamed, and Mahmoud Mohamed Morshed Mohamed
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Chronic rhinosinusitis ,Allergic fungal sinusitis ,Functional endoscopic sinus surgery ,IL5 ,Otorhinolaryngology ,RF1-547 - Abstract
Abstract Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is an allergic response characterized by type 2 inflammatory reactions mediated by T helper 2 cells (Th2). Th2 is characterized by elevated type 2 cytokines related to the humoral response, including Interleukin-4 (IL-4), IL-5, IL-6, IL-9, IL-10, IL-13, IL-25 and IL-33. Allergic fungal sinusitis (AFS) is a distinguishable form of CRSwNP and is characterized by primary localized disease with non-invasive fungal hyphae, which causes immunoglobulin E (IgE)-mediated mucosal hypersensitivity resulting in the formation of eosinophilic mucin. Interleukin-5 (IL-5) is a pro-inflammatory factor that plays a very important role in eosinophil biology. Objective To explore the relation between IL-5 tissue protein expression and AFS. Methods A prospective study performed on 70 patients divided into 2 groups (50 cases of AFS and 20 control who underwent septoplasty and partial inferior turbinectomy) to assess the role of IL5 in AFS compared to control. Results IL-5 was overexpressed in polyps of AFS patients compared to the control group denoting AFS as an eosinophilic mediated type 2 inflammation and highlighting a positive correlation with Lund MacKay radiological score and Sino-nasal Outcome Test (SNOT-22) score for severity of chronic rhinosinusitis (CRS) symptoms. Conclusion IL-5 plays a pivotal role in the pathogenesis and severity of AFS. Thus, our results provide encouraging evidence supporting targeting IL5 as an eligible therapy of promising benefits in AFS. more...
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- 2023
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20. Varied Clinical Presentations of Allergic Fungal Rhinosinusitis-A Case Series.
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Raghvi, A., Priya, K., and Balaji, D.
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ALLERGIC fungal sinusitis , *SYMPTOMS , *SMELL disorders , *PATIENTS , *PARANASAL sinuses , *FUNGAL cultures - Abstract
Fungal sinusitis is broadly classified into invasive and non invasive types. Invasive type presents with fungal hyphae within the mucosa, submucosa, bone, or blood vessels of the paranasal sinuses and includes Acute Invasive Fungal Sinusitis, Acute Fulminant, Chronic Invasive Fungal Sinusitis, Chronic Granulomatous Fungal Sinusitis. Invasive forms of fungal rhinosinusitis are rare and confined to groups of patients who are immunocompromised (Key in Fungal rhinosinusitis). Noninvasive type shows absence of fungal hyphae within the mucosa paranasal sinuses. It includes Allergic Fungal rhinosinusitis, Fungus Ball (fungus mycetoma). The study was performed on a total of 30 patients, in Department of Otorhinolaryngology, at our hospital after getting approved by the Instituitional Human Ethical Committee. We selected 30 patients diagnosed with allergic fungal sinusitis and studied their varied clinical presentations and treatment for a period of 1 year. It was a prospective case series type of study. Patients who presented with symptoms of allergic fungal rhinosinusitis were included. Patients who were referred with complaints of proptosis, diplopia were also included to rule out allergic fungal rhinosinusitis and its complications. Patients diagnosed with chronic granulomatous infection of nose and invasive fungal sinusitis were excluded. Evaluation of patients involved a detailed case history followed by clinical examination and radiologic investigation. After getting proper consent, we did a study of 30 patients who presented to our outpatient department with complaints of sinusitis. Our study included 12 male and 18 female patients. Among these patients, all of them had complaints of frequent allergic rhinosinusitis, nose block, facial heaviness. 12 among them had olfactory disturbances, reduced perception of smell. 4 patients presented with visual disturbances and proptosis which subsided after endoscopic sinus surgery was done.24 among these patients had presence of allergic fungal mucin in their nasal secretions and 10 patients had history of associated atopy and asthma and elevated Ig E levels. And 20 of these patients showed high eosinophil counts. All these patients in our case series were under the age group 22–70 years. These patients were treated with a course of nasal sprays and preoperative steroids in case of extensive polyposis and were taken up for functional endoscopic sinus surgery. Polypoidal mucosa was removed, diseased tissue was cleared, sinus blockage was released and fungal mucin/tissue bits were sent for histopathological analysis, KOH mount and fungal culture. This study included a series of cases which showed a wide range of the various clinical presentations that occur in cases of allergic fungal rhinosinusitis, its diagnosis and treatment. The advantage of this study was we had analyzed a good number of cases with varied presentations. Since AFRS is closely related with EMRS, CRS a proper clinical, radiological and immunological evaluation of the cases help in knowing the correct diagnosis and treatment. [ABSTRACT FROM AUTHOR] more...
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- 2023
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21. Ruptured internal carotid artery aneurysm following surgery for chronic sinusitis: delayed presentation: a case report.
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Al-Domaidat, Derar and Jawad, Jamal
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INTERNAL carotid artery , *ANEURYSMS , *SINUSITIS , *ALLERGIC fungal sinusitis , *FALSE aneurysms - Abstract
Rupture of internal carotid artery aneurysm has high mortality rate and needs high index of suspicion for immediate management. Massive epistaxis after rupture of aneurysms in the petrous part of internal carotid artery is extremely rare. In this paper, we report the first case of delayed rupture of a petrous carotid aneurysm which developed because of chronic allergic sinusitis. [ABSTRACT FROM AUTHOR] more...
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- 2024
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22. Bilateral Orbital Apex Syndrome Related to Sphenoid Fungal Sinusitis.
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Kim, Dong Hyun, Jeong, Jin Uk, Kim, Seul, Kim, Seon Tae, and Han, Gyu Cheol
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ALLERGIC fungal sinusitis , *ENDOSCOPIC surgery , *SPHENOID sinus , *EYE-sockets , *ASPERGILLOSIS , *OPTIC nerve , *ORBITAL diseases , *CRANIAL sinuses , *ENDOSCOPY , *DISEASE complications , *SYMPTOMS - Abstract
Orbital apex syndrome (OAS) is a rare condition that usually occurs due to damage to surrounding inner and surrounding bone tissue. Orbital apex syndrome may result from a variety of conditions that cause damage to the superior orbital fissure and to the optic canal leading to optic nerve (II) dysfunction. We recently experienced a rare case of sphenoidal Aspergillosis, which damaged the adjacent cavernous sinus structures and led to the definite symptom of bilateral OAS in a 77-year-old male. We present this rare case with a brief review of these disease's entities. [ABSTRACT FROM AUTHOR] more...
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- 2023
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23. Comparing Budesonide Via MAD or INSI Prospective Cohort Study
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Amin Javer, Clinical Professor
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- 2020
24. Different Modalities for Management of Pediatric Epiphora.
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Hakeem, Mostafa Talaat Abd-El, Abdallah, Adel, Abdelmoneim, Rasha, Khaleel, Ahmed, and Abdallah, Raafat
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DACRYOCYSTORHINOSTOMY , *NASAL polyps , *ALLERGIC fungal sinusitis , *LACRIMAL apparatus - Abstract
Keywords: pediatric epiphora; pediatric dacryocystorhinostomy; endonasal nasolacrimal intubation; sinonasal pathology EN pediatric epiphora pediatric dacryocystorhinostomy endonasal nasolacrimal intubation sinonasal pathology 1193 1201 9 05/03/23 20230401 NES 230401 Mostafa Talaat Abd-El Hakeem, SP 1 sp Adel Abdallah, SP 1 sp Rasha Abdelmoneim, SP 1 sp Ahmed Khaleel, SP 1 sp Raafat Abdallah SP 2 sp SP 1 sp Otorhinolaryngology Department, Faculty of Medicine, Minia University, Minia, Egypt; SP 2 sp Ophthalmology Department, Faculty of Medicine, Minia University, Minia, Egypt Correspondence: Mostafa Talaat Abd-El Hakeem, Email [email protected] Introduction Congenital epiphora affects up to 20% of all newborns. The third line of invasive treatment, dacryocystorhinostomy (DCR), was performed in 2 cases that failed to resolve after silicone intubation and in 12 patients suffering from recurrent or chronic dacryocystitis (4-12 years old), Figure 3. In our study, the silicone intubation stent was maintained in situ for 3-6 months.[5],[17] The DCR procedure is reserved for intubation-resistant NLDO cases and recurrent or chronic dacryocystitis patients. The results showed that the success rate in children with non-isolated nasolacrimal obstruction was comparable to that in isolated epiphora, possibly because the sinonasal pathology was diagnosed and corrected simultaneously with epiphora.[14] Endoscopic-guided NLD probing is a safe and feasible option as a primary management strategy for epiphora. [Extracted from the article] more...
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- 2023
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25. different clinical presentations of pediatric allergic fungal sinusitis.
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Nahwi, Fawatim A Al, AlMomen, Ali, Alkishi, Sarah A, Almolani, Fadhel, Ameer, Mohammed A Al, Alzubaidi, Aziza A, Suwayyid, Wejdan K, and Alkhars, Abdullah Z
- Subjects
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ALLERGIC fungal sinusitis , *SYMPTOMS , *CHILD patients , *THYROID eye disease - Abstract
In this paper, we aim to study the different clinical presentations of pediatric allergic fungal sinusitis (AFS) in the Eastern Province of Saudi Arabia, and to review the experience in the diagnosis & management of AFS in children at King Fahad Specialist Hospital. This study is a retrospective case series of pediatric patients diagnosed and managed as AFS at a tertiary referral hospital in Saudi Arabia. The clinical presentation of pediatric AFS varies widely and includes unilateral, unilateral with proptosis, bilateral, alternating, isolated sphenoid and extensive with intracranial & intraorbital involvements. Children with AFS present with different clinical features when compared to adults. Therefore, they require a high index of suspicion for evaluation and early aggressive treatment. [ABSTRACT FROM AUTHOR] more...
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- 2023
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26. A case series on allergic fungal rhino sinusitis - variable presentations.
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P., Sengottuvelu, J., Praveen Kumar, K., Semmanaselvan, and S. R., Suvathikha
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- *
ALLERGIC fungal sinusitis , *ENDOSCOPIC surgery , *FACIAL pain , *NASAL polyps , *MAXILLARY sinus diseases , *COMPUTED tomography , *PUBLIC hospitals - Abstract
Allergic fungal rhino sinusitis (AFRS) is a non-invasive fungal sinusitis resulting from an allergic and immunologic response to the presence of extramucosal fungal hyphae in the sinuses. Defined largely by the presence of allergic fungal mucin, which is a thick, tenacious, and eosinophilic secretion with characteristic histologic findings. To present a case series on the variable presentations in patients diagnosed with AFRS. A retrospective study of 10 cases that presented to Rajiv Gandhi Government General Hospital ENT outpatient department with allergic fungal rhinosinusitis confirmed by diagnostic nasal endoscopy and CT scan who were managed successfully by endoscopic sinus surgery. In our study, out of 10 cases, nine patients had unilateral symptoms, only one patient has bilateral symptoms. Most common presentation was headache, facial pain, nasal obstruction, and nasal discharge. Some patients had variable presentations such as proptosis, oroantral fistula, blurring of vision, watering of eye, and unilateral frontal headache. On diagnostic nasal endoscopy, two patients had nasal polyposis. Complete disease clearance was achieved in nine cases by functional endoscopic sinus surgery. Patients were started on topical and oral corticosteroids, pre/postoperatively. On follow-up, only one patient had recurrence. Preventing and treating the condition, as well as its spread and complications, are greatly aided by early detection and management of AFRS. The key to enhancing the result is surgical intervention (endoscopic sinus surgery) and medical therapy (corticosteroids). Antifungals have limited role in treatment of AFRS. Longstanding unilateral Sinusitis should always raise suspicious of AFRS. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
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27. Clinical Manifestations of Human Exposure to Fungi.
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Oliveira, Manuela, Oliveira, Diana, Lisboa, Carmen, Laerte Boechat, José, and Delgado, Luís
- Subjects
- *
ALLERGIC fungal sinusitis , *SYMPTOMS , *PULMONARY aspergillosis , *MYCOSES , *ANTIFUNGAL agents , *ALLERGIES - Abstract
Biological particles, along with inorganic gaseous and particulate pollutants, constitute an ever-present component of the atmosphere and surfaces. Among these particles are fungal species colonizing almost all ecosystems, including the human body. Although inoffensive to most people, fungi can be responsible for several health problems, such as allergic fungal diseases and fungal infections. Worldwide fungal disease incidence is increasing, with new emerging fungal diseases appearing yearly. Reasons for this increase are the expansion of life expectancy, the number of immunocompromised patients (immunosuppressive treatments for transplantation, autoimmune diseases, and immunodeficiency diseases), the number of uncontrolled underlying conditions (e.g., diabetes mellitus), and the misusage of medication (e.g., corticosteroids and broad-spectrum antibiotics). Managing fungal diseases is challenging; only four classes of antifungal drugs are available, resistance to these drugs is increasing, and no vaccines have been approved. The present work reviews the implications of fungal particles in human health from allergic diseases (i.e., allergic bronchopulmonary aspergillosis, severe asthma with fungal sensitization, thunderstorm asthma, allergic fungal rhinosinusitis, and occupational lung diseases) to infections (i.e., superficial, subcutaneous, and systemic infections). Topics such as the etiological agent, risk factors, clinical manifestations, diagnosis, and treatment will be revised to improve the knowledge of this growing health concern. [ABSTRACT FROM AUTHOR] more...
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- 2023
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28. The Role of Serum Galactomannan Assay as a Potential Surrogate Biomarker for Fungal Microinvasion in Allergic Fungal Rhinosinusitis.
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Kanodia, Anupam, Bhalla, Ashu Seith, Singh, Gagandeep, Xess, Immaculata, Valappil, Bashid Valia, Kakkar, Aanchal, Budhiraja, Shilpi, Sikka, Kapil, Irugu, David Victor Kumar, Thakar, Alok, and Verma, Hitesh more...
- Subjects
- *
ALLERGIC fungal sinusitis , *DERMATOPHAGOIDES pteronyssinus , *SKULL base , *MANN Whitney U Test , *BIOMARKERS , *PARANASAL sinuses , *SERUM , *CHLAMYDIA trachomatis - Abstract
We conducted this study to determine if serum galactomannan (GM) can be used as a marker to implicate the invasiveness of allergic fungal rhinosinusitis (AFRS), and correlate this value with the aggressiveness of disease documented via computed tomography (CT). All paranasal CT scans done for AFRS patients prospectively over a five-year period (2015–2019) were included. An indigenous 20-point score was used to document the extent of bone erosion seen on CT, wherein a higher score meant a greater extent of bone erosion. It was then correlated with serum GM scores. The median CT scores of galactomannan-positive (GM+) patients were compared with the median CT scores of galactomannan-negative (GM−) patients 3 using Mann–Whitney U test. The patients were divided into five groups based on the extent of disease-No bone erosion, erosion of only sinus wall/orbit, 3 erosion of orbit and skull base, erosion of only skull base and lateral extension of disease into infratemporal fossa (ITF). Subgroup analysis was conducted over mean GM values in these groups using ANOVA test. p-value < 0.05 was considered significant. Statistical analysis was performed using SPSS version 25.0. A total of 92 patients were included (56 males, 36 females). No statistically significant difference was found (p-value = 0.42) between the CT scores of galactomannan-positive (GM+) group and galactomannan-negative (GM−) group. The mean GM scores amongst the five sub-groups did not show a statistically significant difference. Serum galactomannan values correlate poorly with aggressiveness of disease quantified on non-contrast CT of paranasal sinuses. [ABSTRACT FROM AUTHOR] more...
- Published
- 2023
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29. Role of Radiology in Diagnosis of Allergic Fungal Sinusitis.
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Jamil, Nauman, Afridi, Jahangir Ahmad, Khan, Muhammad, Malik, Kamran Zamurrad, Manzoor, Faisal, and Bhalli, Naeem Riaz
- Abstract
Objective: Investigate the role of serrated turbinates, radiographic abnormalities, and existing literature in aiding the diagnosis of Allergic Fungal Sinusitis (AFS). Study Design: Cross-sectional study Place and Duration of Study: ENT Department Combined Military Hospital, Rawalpindi, Pakistan from Jan 2020 to July 2023. Methodology: One hundred and twenty individuals with computerized tomography scans were included. Patients identified as having Allergic Fungal Sinusitis (AFS) following tests for allergies and/or fungi were placed in the first group, while those identified as having rhinosinusitis (other than AFS) were placed in the second group. CT scans were examined for polyps, bone degradation, the serrated appearance of the turbinate, and CT hyper-density. Results: While comparing the radiology of AFS and non-AFS, it was discovered that the presence of serrated turbinate was prevalent in AFS (p<0.05), with no differences in terms of bone degradation, polyps, or CT hyper-density (p>0.05). The mean age was 36.81±11.24 years. There were 120 patients; 86(72%) were AFS (-ve), and 34(28%) were AFS (+ve) individuals. Out of them, 19(16%) of the AFS (+ve) patients were females, whereas 15(12%) were males. Conclusion: Serrated turbinates may serve as helpful radiological signals in the diagnosis of AFS. For assessing bone erosion in relation to other structural changes, it is important to specify bone density for sinus opacification. [ABSTRACT FROM AUTHOR] more...
- Published
- 2024
30. A Clinico-Pathological Study of Allergic Fungal Rhinosinusitis at a Tertiary Care Center of Western Rajasthan.
- Author
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Choudhary, Sudeep, Solanki, Bharti, Chouhan, Mahendra, and Gupta, Diksha
- Subjects
- *
ALLERGIC fungal sinusitis , *TERTIARY care , *NASAL polyps , *NASAL surgery , *ASPERGILLUS flavus , *NASAL tumors , *PARANASAL sinus diseases - Abstract
Allergic fungal rhinosinusitis (AFRS) is a non-invasive fungal sinusitis resulting from an immunologic response to the presence of extra mucosal fungal hyphae in the sinuses. Here we studied clinicopathological characteristics of AFRS among patients of chronic rhinosinusitis with nasal polyposis who underwent Functional Endoscopic Sinus Surgery (FESS) at a tertiary care in western Rajasthan. Standard ethical protocol was followed for the present study. We did a prospective study on admitted patients of chronic rhinosinusitis with nasal polyposis in the department of Otorhinolaryngology and Head & neck surgery, Dr. S. N. Medical College, Jodhpur from January 2018 to August 2019, who underwent FESS. The patient's history, clinical and endoscopic findings with radiological features were recorded. Biopsy specimens were sent for fungal staining, culture, and histopathology. As per Bent and Kuhn criteria, 25 cases out of 100 were diagnosed as AFRS, mean age was 27.46 ± 13.36. Nasal obstruction and nasal discharge were the most common symptoms. On histopathological examination fungal hyphae found in 18 cases (72%), allergic mucin in 25 cases (100%) and eosinophilic infiltrate in 20 cases (80%). Fungal culture positive in 15 cases (60%) of AFRS. In which aspergillus flavus present in 12 (80%). Allergic fungal rhinosinusitis should be considered as an important differential diagnosis in patients with chronic rhinosinusitis with nasal polyposis and for this surgery should be the treatment of choice. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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31. Impact of Preoperative Steroids Administration on Endoscopic Sinus Surgery: Systematic Review of Literature, and a Survey in Saudi Arabia.
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Assiri, Kholood, Alroqi, Ahmad, Alromaih, Saud, and Alzarei, Ali
- Subjects
- *
ENDOSCOPIC surgery , *ALLERGIC fungal sinusitis , *STEROIDS , *CLINICAL trials , *NASAL polyps - Abstract
There is limited knowledge in the literature and lack of clear protocols among practitioners regarding preoperative steroids administration for patients undergoing endoscopic sinus surgery (ESS). This study aimed to identify the practice patterns of rhinologists in Saudi Arabia as well as systematically review all health-related evidence regarding the use of preoperative steroids for ESS. A previously used questionnaire was modified and distributed in Saudi Arabia among rhinologists who finished their residency training. It entailed questions about their qualifications and preoperative steroids use, preferred regimen, and possible benefits. Also, a systematic literature review using four major databases was conducted to build a scoping view of the current evidence. A total of 94 subjects responded to the mailed survey. Of them, 72(76.6%) used preoperative steroids; 40 subjects believed that there is a strong supporting evidence while 32 reported that there is no solid evidence. The commonest indication was chronic rhinosinusitis with nasal polyp followed by allergic fungal rhinosinusitis. More than half of subjects (54.2%) preferred medium-dose prednisone (30–40 mg/day). A considerable number believed that steroids decreased surgical bleeding (n = 57, 79.2%), improved surgical field visualization (77.8%), decreased surgical time (77.8%), and decreased mucosal inflammation (61.1%). Thirteen studies including 1028 patients were eligible for the systematic review. Only three studies reported a statistically significant effect of steroids in reducing intraoperative hemorrhage, while only two studies revealed that steroids significantly improved surgical field quality. In two studies, steroids showed a significant effect in reducing eosinophil infiltration. There is a major number of rhinology experts using preoperative steroids for patients undergoing ESS but there is a wide variation among their practice patterns. The current potential advantages of steroids need to be supported by further large randomized clinical trials to establish clear guidelines. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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32. Allergic Fungal Otomastoiditis: A Case Report and Review of Literature.
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Singh, Abhijeet, Subash, Anand, Kumari, Neha, and Virk, Ramandeep Singh
- Subjects
- *
ALLERGIC fungal sinusitis , *MIDDLE ear , *AUDIOGRAM , *OTOLARYNGOLOGY ,LITERATURE reviews - Abstract
Allergic fungal otomastoiditis, a rare known entity has only been published as case reports in literature. There have been 3 cases of adult and 1 case of pediatric allergic fungal otomastoiditis reported as of now. A young male had unilateral otorrhea and hearing difficulty for four years. The audiogram revealed moderate conductive hearing loss and radiograph showed complete opacification of tympanic cavity. He underwent tympano-mastoidectomy, showing polypoidal granulations and thick mucoid discharge. The histopathology was a surprise diagnosis of Allergic fungal otomastoiditis. The clinical and histopathological appearance of this entity matches allergic fungal rhinosinusitis. After extensive review of literature, we propose a working criterion for early identification of allergic fungal otomastoiditis in otolaryngology setting. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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33. RADIOLOGICAL EVALUATION OF ALLERGIC FUNGAL SINUSITIS: NOVEL FINDINGS
- Author
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Neslihan Sarı and Fatih Çankal
- Subjects
allergic fungal sinusitis ,serrated turbinate ,bone erosion ,radiology ,alerjik fungal sinüzit ,serrated konka ,kemik erozyon ,radyoloji ,Medicine - Abstract
AIM Fungal sinusitis is a disease that was previously considered a rare disease, but has recently been reported with increasing frequency in warm climates. Fungal sinusitis classification has evolved over the past two decades and is said to include five subtypes. Discrimination of different subtypes and knowing their radiological features are important for accurate and rapid diagnosis and initiation of appropriate treatment. In our study, we aimed to investigate whether there is a difference between the radiological findings of AFS with a newly defined finding that may help the diagnosis of AFS; serrated turbinate and those reported in the literature. MATERIALS AND METHODS Our study included 120 patients who underwent paranasal sinus computed tomography examination in our center between January 2019 and September 2021. Patients diagnosed with AFS as a result of allergic tests and/or fungal culture examinations were included in the first group, and patients diagnosed with non-AFS rhinosinusitis were included in the second group. Presence of serrated turbinate appearence, polyps, bone erosion, CT hyperdensity were evaluated in the images. RESULTS The radiological features of AFS and non-AFS were compaired and serrated turbinate appearence was found to be statistically signifant in AFS (p0.05). CONCLUSION Our findings showed that serrated turbinate appearence may be a useful radiological marker in the diagnosis of AFS. Bone erosion should be evaluated seperately from other morphological and structural changes in the bone structure, and the bone density measurements should be specified for sinus opacification. more...
- Published
- 2021
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34. Noninvasive fungal rhinosinusitis: a case series [version 2; peer review: 2 approved]
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Mohamed Masmoudi, Jihene Chelli, Asma Ben Mabrouk, Ezer Chebil, Wadii Thabet, Mehdi Hasnaoui, and Khalifa Mighri
- Subjects
Clinical Practice Article ,Articles ,allergic fungal sinusitis ,fungal ball ,diagnosis ,surgery ,treatment - Abstract
Introduction: Fungal rhinosinusitis (FRS) remains a rare disease. The noninvasive forms are hard to diagnose. The management protocols remain controversial. We aim to describe the clinical, radiological and pathological features of noninvasive FRS and present our management protocol and follow-up results. Patients and methods: This descriptive study was conducted in the ear-nose-throat department of the university hospital, Taher Sfar in Mahdia, Tunisia. All patients who responded to the definition of noninvasive FRS (fungal balls and allergic fungal sinusitis) were included. The study was conducted over a three year period (May 2017 – April 2021). Results: Eleven patients were included in this study: four cases of fungal balls and seven cases of allergic fungal sinusitis. Patients presented with symptoms of chronic recurrent rhinosinusitis with no response to conventional treatments. Computed tomodensitometry scan showed opacification of the paranasal sinuses in all patients. Other signs were heterogeneous opacities, local calcifications and thinning of the bony walls of the sinuses. Histopathological findings were inflammatory polyps in all cases of allergic FRS with the presence of fungal hyphae in 42.8% of the cases. All patients underwent surgery after a median delay of 12 [6–24] months of the symptom’s onset. The used procedures were endoscopic middle meatal antrostomy for all patients, ethmoidectomy (81.8%) and sphenoidotomy (36.4%). None received systemic antifungals or corticosteroids with a favorable outcome in all cases. Conclusion: Symptoms of noninvasive FRS are nonspecific. The scan images contribute to the diagnosis, but the perioperative findings and the histopathological results remain crucial. The management is mainly surgical. more...
- Published
- 2022
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35. Second-Hand Smoke and Early Allergic Manifestation in Children.
- Author
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Sitisalma Amirah Dzakiyyah, Anang Endaryanto, Linda Dewanti, Azwin Mengindra Putera, and Anisa Ayu Maharani
- Subjects
RESEARCH ,RESPIRATORY diseases ,SKIN diseases ,SCIENTIFIC observation ,ALLERGIC fungal sinusitis ,CROSS-sectional method ,RISK assessment ,SOFTWARE architecture ,MEDICAL records ,DESCRIPTIVE statistics ,PASSIVE smoking ,ALLERGIES ,SMOKING ,ENVIRONMENTAL exposure ,DISEASE risk factors ,CHILDREN - Published
- 2022
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36. Noninvasive fungal rhinosinusitis: a case series [version 1; peer review: 1 approved, 1 approved with reservations]
- Author
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Mohamed Masmoudi, Jihene Chelli, Asma Ben Mabrouk, Ezer Chebil, Wadii Thabet, Mehdi Hasnaoui, and Khalifa Mighri
- Subjects
Clinical Practice Article ,Articles ,allergic fungal sinusitis ,fungal ball ,diagnosis ,surgery ,treatment - Abstract
Introduction: Fungal rhinosinusitis (FRS) remains a rare disease. The noninvasive forms are hard to diagnose. The management protocols remain controversial. We aim to describe the clinical, radiological and pathological features of noninvasive FRS and present our management protocol and follow-up results. Patients and methods: This descriptive study was conducted in the ear-nose-throat department of the university hospital, Taher Sfar in Mahdia, Tunisia. All patients who responded to the definition of noninvasive FRS (fungal balls and allergic fungal sinusitis) were included. The study was conducted over a three year period (May 2017 – April 2021). Results: Eleven patients were included in this study: four cases of fungal balls and seven cases of allergic fungal sinusitis. Patients presented with symptoms of chronic recurrent rhinosinusitis with no response to conventional treatments. Computed tomodensitometry scan showed opacification of the paranasal sinuses in all patients. Other signs were heterogeneous opacities, local calcifications and thinning of the bony walls of the sinuses. Histopathological findings were inflammatory polyps in all cases of allergic FRS with the presence of fungal hyphae in 42.8% of the cases. All patients underwent surgery after a median delay of 12 [6–24] months of the symptom’s onset. The used procedures were endoscopic middle meatal antrostomy for all patients, ethmoidectomy (81.8%) and sphenoidotomy (36.4%). None received systemic antifungals or corticosteroids with a favorable outcome in all cases. Conclusion: Symptoms of noninvasive FRS are nonspecific. The scan images contribute to the diagnosis, but the perioperative findings and the histopathological results remain crucial. The management is mainly surgical. more...
- Published
- 2021
- Full Text
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37. Identification of Bacterial and Fungal Isolates in Patients with Sinonasal Polyps.
- Subjects
ALLERGIC fungal sinusitis ,PARANASAL sinus diseases ,MICROBIAL sensitivity tests ,INTRANASAL administration ,THERAPEUTICS ,NASAL polyps - Abstract
The clinical trial NCT06637449 aims to detect bacterial and fungal growth in patients with sinonasal polyps undergoing FESS. Chronic rhinosinusitis with nasal polyps affects 0.5% to 4% of the global population and is characterized by mucosal thickening and polyp formation. The study focuses on identifying bacterial and fungal isolates in patients with this condition to inform medical and surgical management strategies. [Extracted from the article] more...
- Published
- 2024
38. Bilateral proptosis—an unusual presentation of extensive allergic fungal sinusitis.
- Author
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Almomen, Ali, Al-enzi, Omar, Alshammari, Reem, Molani, Fadel, Alshakhs, Abdullah A, Ameer, Mohammed A Al, Alarim, Raghad A, Alfalah, Mohammed A, and Marhoon, Jenan A
- Subjects
- *
EXOPHTHALMOS , *SALINE irrigation , *SYMPTOMS , *EYESTRAIN , *ALLERGIC fungal sinusitis - Abstract
Allergic fungal rhinosinusitis (AFRS) is counted as the most common form of fungal sinusitis. It is mainly due to the hypersensitivity reaction to fungal infection. Usually, the patients are atopic or immunocompetent. These patients are usually suffering from signs and symptoms of rhinosinusitis. The expanding mass in the disease leads to bony remodeling and the involvement of adjacent structures. When allergic mucin involves the orbit, many complications may occur. This includes diplopia, telecanthus, unilateral proptosis, malar flattening, epiphora, Asthenopia and even visual loss. The diagnosing of AFRS initially requires radiographic imaging, but to confirm the diagnosis, histopathological examination is needed. The treatment of AFRS should be combined with surgical and medical therapy. This case report demonstrates a unique and rare presentation of the non-invasive AFRS with bilateral proptosis which had dramatic improvement and resolution after we managed it with endoscopic sinus surgery, steroids and nasal saline irrigation. [ABSTRACT FROM AUTHOR] more...
- Published
- 2022
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39. IL-25 and IL-33 Serum Levels are not Associated with the Type of Allergen Causing Allergic Rhinitis
- Author
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Reza Abbasi, Kamiar Zomorodian, Zahra Zare Shahrabadi, Farshid Saadat, Seyed Hesamedin Nabavizadeh, Hossein Esmaeilzadeh, and Sohila Alyasin
- Subjects
allergic fungal sinusitis ,interleukin-25 ,interleukin-33 ,ige ,Biology (General) ,QH301-705.5 - Abstract
Background: Fungal aeroallergens might sensitize the airway which in turn produces a specific cytokine profile. Objective: To evaluate the IL-25 and IL-33 profile in patients with fungal allergic rhinitis. Methods: The present study examined patients who were evaluated due to allergic rhinitis (AR) at Emam Reza Hospital of Shiraz, Iran. The allergic patients were categorized based on the skin prick test. Blood samples were collected and allergen-specific IgE and cytokine profiles were analyzed. Results: 184 patients were enrolled in the study and in 35 of whom fungal rhinitis was confirmed. The levels of specific IgE in patients with fungal allergy were statistically significant compared to those in the control group (pConclusion: Chronic fungal challenge might regulate innate system cytokines in severe persistent AR. more...
- Published
- 2019
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40. Value of MRI signal intensity in evaluation of allergic fungal rhinosinusitis compared with CT Hounsfield units: Retrospective study.
- Author
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Alsalem S, Almontashri A, Alsalem M, Altamimi F, Alyami N, Hajjaf S, and Ahmed F
- Subjects
- Humans, Female, Male, Retrospective Studies, Adult, Middle Aged, Young Adult, Mycoses diagnostic imaging, Mycoses diagnosis, Adolescent, ROC Curve, Saudi Arabia, Sensitivity and Specificity, Allergic Fungal Sinusitis, Magnetic Resonance Imaging methods, Tomography, X-Ray Computed methods, Sinusitis diagnostic imaging, Sinusitis microbiology, Rhinitis, Allergic diagnostic imaging
- Abstract
"Allergic fungal sinusitis (AFS)" is typically diagnosed using radiologic images like computed tomography (CT) scans and magnetic resonance imaging (MRI), with the "Hounsfield unit (HU)" in CT scans and T2-weighted images (T2WI) in MRI serving as reliable objective parameters. However, diagnosing AFS might be difficult because of possible signal changes and densities caused by variations in the secretion concentration in the sinus. Few studies have compared the diagnostic performance of MRI and CT scans. This study aimed to investigate the value of MRI signal intensity in evaluating AFS compared with CT HUs. This retrospective study included 111 patients with pathologically confirmed AFS who underwent CT imaging followed by MRI evaluation at King Saud Medical City, Riyadh, Saudi Arabia, from January 2012 to December 2022. Radiographic densities of sinus opacities on CT scan, including the mean HU values, and MRI findings, including signal voids on T1-weighted images and T2WI, were gathered and analyzed. To determine the efficacy of these radiographic characteristics in predicting the disease and the best cutoff value, we employed receiver operator characteristic curves. The mean age was 31.9 ± 15.6 years, and most patients were 74 females (66.7%). The main symptom was nasal obstruction in 73 patients (65.8%). In comparison, between HU and signal void on T2WI, there was moderate predictive performance [area under the curve: 0.856, P = .001]. An ideal HU cutoff value of 69.50 HU was obtained with a sensitivity of 100% and a specificity of 44.7%. However, the receiver operator characteristic for T1-weighted images could not be plotted, as no signal was avoided to predict AFS and it was not statistically significant (area under the curve: 0.566; P = .287). The study found a CT HU of 69.5 can predict MRI T2WI signal values with a void signal, aiding in diagnostic workup and evaluation for AFS., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.) more...
- Published
- 2024
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41. Manifestation and associated factors of systemic and local allergy among patients with allergic fungal rhinosinusitis: An observational study.
- Author
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Vo AB, Thai TT, Pham DL, and Pham HK
- Subjects
- Humans, Female, Male, Middle Aged, Adult, Aged, Nasal Provocation Tests, Immunoglobulin E blood, Prevalence, Mycoses immunology, Mycoses epidemiology, Mycoses diagnosis, Mycoses complications, Allergic Fungal Sinusitis, Sinusitis immunology, Sinusitis microbiology, Sinusitis complications, Sinusitis epidemiology, Sinusitis diagnosis, Rhinitis, Allergic immunology, Rhinitis, Allergic epidemiology, Rhinitis, Allergic complications, Rhinitis, Allergic diagnosis, Skin Tests
- Abstract
Allergic fungal rhinosinusitis (AFRS) is a subtype of chronic rhinosinusitis, characterized by excessive immune responses to environmental molds or fungi. The diagnosis and classification of AFRS into systemic and local types remain clinically challenging due to overlapping characteristics. This study investigated the prevalence of AFRS, its manifestation and associated factors in systemic and local AFRS. A total of 200 patients diagnosed with fungal rhinosinusitis underwent both skin provocation tests (SPT) and nasal provocation tests (NPT) to confirm AFRS and classify systemic and local types. Patients were considered to have AFRS if either the SPT or NPT was positive. Among these, patients with systemic AFRS were those who had a SPT positive. Local AFRS was when patients had a negative SPT and a positive NPT. Medical history, serum total IgE level, nasal endoscopy examinations, and CT scans were also recorded. Most patients were female (65.8%), with a mean age of 55.6 years (SD = 14.4). Based on the SPT and NPT results, 31% of patients (n = 62) were diagnosed with AFRS. Among these, 54.8% (n = 34) had systemic AFRS, while 45.2% (n = 28) had local AFRS. Patients with AFRS exhibited significantly higher levels of total IgE, eosinophils, and more pronounced signs and symptoms compared to those without AFRS. However, no statistically significant differences were observed between patients with systemic AFRS and those with local AFRS. AFRS was prevalent in our study. Among patients with AFRS, both systemic AFRS and local AFRS were also prevalent. While allergic indicators and clinical presentations can aid in AFRS diagnosis, minimal distinctions were observed between systemic and local AFRS. A comprehensive assessment incorporating both local and systemic allergic responses through provocation tests, such as a combination of skin and nasal tests, is imperative for optimizing AFRS diagnosis and management., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.) more...
- Published
- 2024
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42. Aetiological Subclassification of Chronic Rhinosinusitis: A Retrospective Study
- Author
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Turki M Bin Mahfoz and Talal Alandejani
- Subjects
allergy ,allergic fungal sinusitis ,asthma ,immunoglobulin e ,nasal polyps ,Medicine - Abstract
Introduction: Chronic Rhinosinusitis (CRS) is a major health problem with very high prevalence worldwide. The information available about the pathophysiology of the disease is not enough to allow development of curative therapies. Classification of CRS is based on the presence of asthma and allergy that can be useful to understand the disease aetiology and allow better patient’s care through individualised treatment plans. Aim: To classify CRS cases into subgroups depending mainly on the presence of asthma and allergy in addition to comparing the characteristics of these subgroups. Materials and Methods: A retrospective descriptive study was carried out, and the data of CRS’ patients were collected from medical records of consecutive patients attending the ENT clinic in, King Abdulaziz Medical City, Saudi Arabia. Based on collected data, CRS cases were classified into six subclasses, and patients’ characteristics such as gender and Immunoglobulin E (IgE) values in these subclasses were compared. Data entry and statistical analysis was carried out in Statistical Package for the Social Sciences (SPSS). Mean, Standard Deviation (±SD) for numerical parametric variables and Inter-Quartile Range (IQR) for numerical non-parametric variables was calculated. Appropriate statistical tests like Analysis of Variance (ANOVA) for parametric data and Kruskal Wallis test for non-parametric were applied. Results: The most prevalent subclass was Non-Asthmatic Sinusitis without Allergy (NASsA) 30 (48.4%) followed by, Asthmatic Sinusitis Without Allergy (ASsA) 13 (21.0%), Asthmatic Sinusitis With Allergy (AScA) 6 (9.7%), Non-Asthmatic Sinusitis With Allergy (NAScA) 5 (8.1%) and Allergic Fungal Sinusitis (AFS) 5 (8.1%). The highest levels of total IgE were found in patients with NAScA. It was found that nasal polyps’ presence was significantly linked to higher Computed Tomography (CT) Lund-Macky scores and MASNOT (Modified Arabic Sino-Nasal Outcome Test) scores. Conclusion: Classification of CRS based on the presence of asthma and allergy can be an informative tool for providing better care to CRS patients. more...
- Published
- 2020
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43. Isolated sphenoid allergic fungal sinusitis causing bilateral blindness
- Author
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Eugene Wong and Narinder Singh
- Subjects
Sphenoid ,Allergic fungal sinusitis ,Blindness ,Bilateral ,Otorhinolaryngology ,RF1-547 - Abstract
Bilateral blindness secondary to isolated sphenoid allergic fungal sinusitis is rare, particularly in the immunocompetent patient. We describe the case of a 29 year old female who presented with gradual deterioration in vision in both eyes, secondary to an expansile, heterogenous lesion centred in the sphenoid sinuses. Dihisence and lateral distension of the nerves were noted. Following urgent decompression and debridement of the sinus, histology was consistent with a diagnosis of allergic fungal sinusitis. In this manuscript we describe the case in detail and the potential causes of the rare presentation of visual deterioration secondary to allergic fungal sinusitis. more...
- Published
- 2020
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44. Key role of inferior turbinectomy and partial middle turbinectomy in endoscopic surgery for allergic fungal sinusitis: A comparative study
- Author
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Ahmad Mostafa, Wael A Alzamil, Essam Fatehy, and Mohammad M Gaballah
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allergic fungal sinusitis ,inferior turbinectomy ,partial middle turbinectomy ,Medicine - Abstract
Background Proper eradication of allergic fungal sinusitis (AFS) depends on three factors: first is proper preoperative evaluation and mapping via computed tomography and MRI. Second is the availability of adequate surgical tools in experienced hands. Third is the proper postoperative endoscopic follow-up to detect and remove recurrence if possible. Aim To evaluate the role of inferior turbinectomy (IT) and partial middle turbinectomy (PMT) in patients with AFS managed by endoscopic sinus surgery (ESS) for the prevention of recurrence and adequate management of residual disease (postoperative salvage). Patients and methods A prospective, comparative, randomized study conducted from March 2016 to April 2018. In all, 28 patients suffering from AFS were included. All patients have been presented and managed at the Department of Otolaryngology, Hearing and Speech Institute. Patients have been randomized into two groups of 14 patients each (groups A and B). The patients in group A have undergone ESS only, while the patients in group B have undergone ESS plus bilateral IT and PMT. Regular follow-up visits were done every 2 months for at least 6 months for both groups. Results In group A, there was difficulty in proper assessment in 11 patients out of 14. Recurrence occurred in five patients who showed rigorous assessment, which was managed via ESS adding to the maneuver bilateral IT and PMT. In group B, only two patients were difficult out of the 14. Recurrence occurred in two patients only and was managed easily in the outpatient office. No significant complications were detected in both groups. Conclusion IT and PMT may be considered as essential steps in the surgery for AFS as they play a role in lowering the recurrence rate and facilitating better, more comfortable, and more effective postoperative management of recurrence if happened. more...
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- 2019
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45. Sinonasal Risk Factors for Occurrence of Unilateral Versus Bilateral Allergic Fungal Rhinosinusitis.
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ALLERGIC fungal sinusitis ,PARANASAL sinuses ,NASAL polyps ,IMMUNOGLOBULIN E - Abstract
A clinical trial, NCT06376071, has been launched to assess sinonasal risk factors for the occurrence of unilateral versus bilateral allergic fungal rhinosinusitis. The study aims to examine anatomical variations and correlate radiological findings with intraoperative findings, as well as other associated factors such as demographic, environmental, immunological, and climatic risk factors. Allergic fungal rhinosinusitis is a subtype of chronic rhinosinusitis with nasal polyposis that is characterized by eosinophilic mucin and hypersensitivity to fungal elements. The disease prevalence varies based on climatic, socioeconomic, and geographic factors. The trial is observational and has not yet started recruiting participants. [Extracted from the article] more...
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- 2024
46. Recurrence Pattern and Complication Rate of Allergic Fungal Sinusitis: A 10-Year Tertiary Center Experience.
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Alghonaim, Yazeed, Alfayez, Abdulrhman, Alhedaithy, Riyadh, Alsheikh, Abdullah, and Almalki, Malak
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DISEASE relapse , *NASAL polyps , *SYMPTOMS , *ENDOSCOPIC surgery , *ALLERGIC fungal sinusitis - Abstract
Background. Allergic fungal rhinosinusitis is a noninvasive form of highly recurrent chronic rhinosinusitis. Despite the advancement in medical and surgical strategies, recurrence in AFRS in general poses another challenging problem with reported incidence that eventually can reach more than 60%. Recognition and understanding the pattern of disease recurrence will lead to greater understanding of the disease response in our population. Method. A retrospective cohort study was performed in King Abdulaziz Medical City in Riyadh, Saudi Arabia. All patients diagnosed with chronic rhinosinusitis and underwent functional endoscopic sinus surgery from the period of January 2006 to December 2016 were reviewed. Results. 28 patients were found to have AFRS based on clinical, radiological, and microscopic examination suggestive of allergic fungal rhinosinusitis. Among these patients, 53% of them were female and 46% were male. The age ranged from 13 to 55 years, with a mean age of 31.57 years. 28.57% of the patients presented with recurrent allergic fungal sinusitis. The duration between the surgery and symptoms recurrence was around one year. Male and female patients had similar recurrence rate (50%). At first visit, 95% of the patients with nonrecurrent disease presented with nasal obstruction compared to 87.5% of the patients with recurrent disease. On the other hand, patients with recurrent disease had more nasal discharge (87.5%), postnasal drip (37.5%), facial pressure/pain (50%), headache (50%), nasal polyposis (87.5%), hypertrophy of inferior turbinate (37.5%), and proptosis (12.5%). Nasal obstruction (87.5%) and nasal polyps (87.5%) were the most common presenting symptoms for the disease recurrence. The pattern of disease recurrence in the previously unilateral disease was 18% ipsilateral and 27% bilateral. For the patients who had bilateral disease formerly, 17% (n = 3) of them had recurrent bilateral disease. Conclusion. Allergic fungal rhinosinusitis is a distinct clinical entity. A high recurrence rate is a pathognomonic feature of the disease, despite all the development in medical and surgical trials. This study demonstrated that recurrence rate is lower in our population. However, more studies with a greater number of patients are needed in the future to clearly recognize the pattern of recurrence in patients with AFRS. [ABSTRACT FROM AUTHOR] more...
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- 2020
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47. Aetiological Subclassification of Chronic Rhinosinusitis: A Retrospective Study.
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MAHFOZ, TURKI M. BIN and ALANDEJANI, TALAL
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ETIOLOGY of diseases ,IMMUNOGLOBULIN E ,SINUSITIS ,PATIENT care ,DATA entry ,ATOPY - Abstract
Introduction: Chronic Rhinosinusitis (CRS) is a major health problem with very high prevalence worldwide. The information available about the pathophysiology of the disease is not enough to allow development of curative therapies. Classification of CRS is based on the presence of asthma and allergy that can be useful to understand the disease aetiology and allow better patient's care through individualised treatment plans. Aim: To classify CRS cases into subgroups depending mainly on the presence of asthma and allergy in addition to comparing the characteristics of these subgroups. Materials and Methods: A retrospective descriptive study was carried out, and the data of CRS' patients were collected from medical records of consecutive patients attending the ENT clinic in, King Abdulaziz Medical City, Saudi Arabia. Based on collected data, CRS cases were classified into six subclasses, and patients' characteristics such as gender and Immunoglobulin E (IgE) values in these subclasses were compared. Data entry and statistical analysis was carried out in Statistical Package for the Social Sciences (SPSS). Mean, Standard Deviation (±SD) for numerical parametric variables and Inter-Quartile Range (IQR) for numerical non-parametric variables was calculated. Appropriate statistical tests like Analysis of Variance (ANOVA) for parametric data and Kruskal Wallis test for non-parametric were applied. Results: The most prevalent subclass was Non-Asthmatic Sinusitis without Allergy (NASsA) 30 (48.4%) followed by, Asthmatic Sinusitis Without Allergy (ASsA) 13 (21.0%), Asthmatic Sinusitis With Allergy (AScA) 6 (9.7%), Non-Asthmatic Sinusitis With Allergy (NAScA) 5 (8.1%) and Allergic Fungal Sinusitis (AFS) 5 (8.1%). The highest levels of total IgE were found in patients with NAScA. It was found that nasal polyps' presence was significantly linked to higher Computed Tomography (CT) Lund-Macky scores and MASNOT (Modified Arabic Sino-Nasal Outcome Test) scores. Conclusion: Classification of CRS based on the presence of asthma and allergy can be an informative tool for providing better care to CRS patients. [ABSTRACT FROM AUTHOR] more...
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- 2020
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48. Fungal Pneumonia in The Immunocompetent Host: A Possible Statistical Connection Between Allergic Fungal Sinusitis with Polyposis and Recurrent Pulmonary Infection Detected by Gastroesophageal Reflux Disease Scintigraphy.
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Burton, Leticia, Baumgart, Karl, Novakovic, Daniel, Beattie, John, Joffe, David, Falk, Gregory, and Van der Wall, Hans
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RADIONUCLIDE imaging , *GASTROESOPHAGEAL reflux , *LUNG infections , *COMPUTED tomography , *MYCOSES , *PNEUMONIA , *ALLERGIC fungal sinusitis - Abstract
Objectives: Fungal pneumonia in the immune competent host is a rarity with few reported cases in the literature. We present a series of 7 cases of recurrent fungal pneumonia in association with allergic fungal rhinosinusitis and gastroesophageal reflux disease (GERD). We hypothesised that recurrent infection may have been transported from the infected paranasal sinuses into the lung by GERD as the process was terminated by surgical fundoplication in 2 of these patients. Methods: Patients were recruited into the study if they were immune competent and had recurrent fungal pneumonia and GERD. Allergic fungal rhinosinusitis was proven by biopsy. GERD was investigated by a scintigraphic test that assessed local oesophageal disease, lung aspiration and head and neck involvement with a hybrid gamma camera and X-ray computed tomography. Results: All patients were shown to have GERD with 5/7 showing paranasal sinus contamination and 7/7 showing laryngopharyngeal involvement and 6/7 lung aspiration. One patient had characteristics strongly predictive of aspiration. Fundoplication led to cessation of fungal lung infection in two patients. Conclusion: Recurrent fungal pneumonia in the immune competent host should raise the possibility of re-infection from the paranasal sinuses, especially in patients with GERD. [ABSTRACT FROM AUTHOR] more...
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- 2020
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49. Allergic Fungal rhino-sinusitis frequency in chronic rhino-sinusitis patients and accuracy of fungal culture in its diagnosis.
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Awan, Nukhbut-Ullah, Cheema, Khalid Muneer, Naumeri, Fatima, and Qamar, Samina
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ALLERGIC fungal sinusitis , *FUNGAL cultures , *NASAL polyps , *ENDOSCOPIC surgery , *BONES , *EOSINOPHILIA , *PARANASAL sinus diseases , *MAXILLARY expansion , *PULMONARY eosinophilia - Abstract
Objective: To determine the frequency of Allergic Fungal Rhino-sinusitis (AFRS) in Chronic Rhino-sinusitis (CRS) patients and the accuracy of fungal culture in diagnosing AFRS. Methods: Immunocompetent patients with CRS and without invasive fungal rhino-sinusitis presenting over a period of 3 years in ENT department of Mayo Hospital, from April 2014 to September 2017 were included in the study. AFRS was diagnosed clinically and on Bent and Kuhn diagnostic criteria. All patients underwent endoscopic sinus surgery. Removed tissue histopathology and fungal culture was done. Diagnostic accuracy of fungal culture in AFRS patients was determined. Results: Out of 216 patients of CRS, 45 (20.8%) had AFRS. Mean age of patients diagnosed with AFRS was 29.49±9.16. Out of 45 patients, 26 were male and 19 were female. Nasal polyps were present in 45 (100%) patients, fungal stain was positive in 39(86.7%). CT scan showed sinus expansion in 28(62.2%) patients, heterogeneous opacity in 45(100%) patients and bone destruction in 13(28.9%). Presence of Allergic Mucin was seen in 45(100%) patients, high IgE levels in 36(80.0%), eosinophilia in 21(46.7%), presence of Charcot Leyden crystals in 27(60.0%). Asymmetrical involvement of sinuses was seen in 30 (66.7%) and co-existent asthma was seen in 18(40.0%). Fungal culture positive patients were 25(55.6%). Diagnostic accuracy of fungal culture was 91.6%. Conclusion: Fungal culture has a key role in confirming diagnosis of AFRS. We also noted that frequency of AFRS is increasing in CRS patients. [ABSTRACT FROM AUTHOR] more...
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- 2020
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50. Allergic fungal sinusitis presenting as optic neuritis: A diagnostic dilemma
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R Neena and Mathew Dominic
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allergic fungal sinusitis ,best corrected visual acuity ,computerized tomography ,functional endoscopic sinus surgery ,magnetic resonance imaging ,optic neuritis ,relative afferent pupillary defect ,Ophthalmology ,RE1-994 - Abstract
Aim: To familiarize ophthalmologists with the rare but potentially vision-threatening complication of optic neuritis from allergic fungal sinusitis. This is a case report of a healthy young female who presented with rapidly deteriorating vision and clinical features of acute optic neuritis of the left eye. Computerized tomography of the brain and orbits revealed an invasive bilateral sphenoid sinus mass with encasement of the left optic nerve, bone erosion, and intracranial extension. Ear, nose, and throat examination revealed nasal polyposis with sinusitis. Endoscopic biopsy revealed extensive allergic fungal debris filling sinuses and eroding the medial end of the optic canal on left side suggestive of allergic fungal sinusitis. An emergency functional endoscopic sinus surgery and optic nerve decompression followed by systemic steroid therapy restored her vision. The culture of the nasal biopsy grew Aspergillus fumigatus. more...
- Published
- 2019
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