scholarly journals Predictor of Recurrence of Allergic Fungal Rhinosinusitis

2021 ◽  
Author(s):  
yanmin Chen ◽  
Hongtao Zhen
Keyword(s):  
Evaluation System ◽  
Age Of Onset ◽  
Clinical Manifestations ◽  
Sinus Surgery ◽  
Chinese Patients ◽  
Management Approach ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Duration Of Symptoms

Abstract ObjectivesBy analyzing the clinical manifestations related to allergic fungal sinusitis (AFRS), the aim of this study was to try to make the first step to establish a prognostic evaluation system for predicting the recurrence of AFRS patients after operating.MethodsA descriptive and retrospective study of 19 AFRS out of 272 chronic rhinosinusitis (CRS) who underwent endoscopic sinus surgery were enrolled from April 2011 to April 2019. ResultsThe incidence of AFRS was 7.0% (19/272) in this study. The postoperative recurrence rate was 26.3% (5/19). Nasal discharge (73.7%) and nasal obstruction (57.9%) were the most common clinical manifestations. There were significant differences in the age of onset, preoperative duration of symptoms and a total Lund-MacKay CT score between the relapsing group and non-relapsing group.ConclusionsAFRS is less prevalent and high recurrent in Chinese patients. Our preliminary data support that age, duration and Lund-MacKay CT scores as the focus of preoperative clinical evaluation of AFRS: a long duration of symptoms (≥15 months) and a high Lund-MacKay CT score (≥11) are at a high risk of relapse, in further prospective and larger investigations as part of the preoperative work-up for patients with AFRS in order to develop a personalized and effective management approach.

scholarly journals Allergic fungal rhinosinusitis: an overview on pathogenesis, early diagnosis and management

2018 ◽  
Vol 4 (3) ◽  
pp. 694 ◽  
Author(s):  
Neeraj Suri ◽  
Bhavya B. M.
Keyword(s):  
Nasal Obstruction ◽  
Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Histological Evaluation ◽  
Nasal Discharge ◽  
Fungal Sinusitis ◽  
Surgical Specimen ◽  
Specimen Handling ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

<p class="abstract"><strong>Background: </strong>The objective of the study was<strong> </strong>to evaluate the criteria for diagnosing allergic fungal rhinosinusitis and to maintain permanent drainage and ventilation, while preserving the integrity of the mucosa.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 50 patients with allergic fungal sinusitis with or without polyposis all of whom were treated with endoscopic debridement. Mucous sample collection, nasal secretion culture, surgical specimen handling, and histological evaluation of surgical specimens are described. All patients treated with endoscopic sinus surgery, debridement, post-operative use of steroids and antifungal therapy.  </p><p class="abstract"><strong>Results:</strong> Fungal mucin was found in all 50 cases, histology and fungal cultures confirmed the diagnosis. Out of 50 patients, 29 were females and 21 were males, with a mean age of 32 years. The most common symptom was nasal discharge 41 (82%) cases, nasal obstruction in 38 (76%) cases, headache and facial pain in 32 (72%) cases, 7 (14%) patients had bronchial asthma. Symptoms of nasal obstruction and nasal discharge were improved in 46 (92%) cases. All preoperative versus postoperative changes in AFRS associated complaints reached statistical significance of p value &lt;0.001 except in patients with asthma.</p><p class="abstract"><strong>Conclusions:</strong> Comprehensive management with endoscopic sinus surgery, oral steroids and antifungals reduces the recurrence or need for revision surgery. Long term follow up is very important.</p>

scholarly journals Management of testicular torsion <360° in children: a single-center, retrospective study

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051989586
Author(s):  
Xiang Guo ◽  
Lan Sun ◽  
Wei Lei ◽  
Shuang Li ◽  
Hui Guo
Keyword(s):  
Blood Flow ◽  
Retrospective Study ◽  
Survival Rate ◽  
Physical Examination ◽  
Testicular Torsion ◽  
Age Of Onset ◽  
Clinical Manifestations ◽  
Single Center ◽  
Laboratory Examination ◽  
Duration Of Symptoms

Objective This study aimed to summarize clinical manifestations, and physical examination, laboratory examination, and ultrasound results of children with testicular torsion <360°. Methods We performed a retrospective study of children who were diagnosed with testicular torsion <360° between October 2007 and October 2017. Results There were 11 (19.2%) patients with testicular torsion of 90°, 33 (58.0%) with 180°, and 13 (22.8%) with 270°. The median age of onset was 5.7 years (range, 1–14 years) and the median duration of symptoms was 4.2 days (range, 0.5–5 days). Ultrasound showed low blood flow in 46 (80.8%) patients. The testis was retained in 41 (72.0%) patients and resected in 16 (28.0%). The testes appeared necrotic at 2 to 3 days after onset for patients with 270° torsion, appeared necrotic at 3 to 4 days after onset for those with 180° torsion, and were not necrotic at 4 to 5 days after onset for those with 90° torsion. The duration of symptoms in children decreased as the torsion angle increased. Conclusion Children with testicular torsion <360° are relatively young, while the duration of symptoms is relatively long. A high postoperative testicular survival rate is one of the clinical features in this study.

Allergic fungal rhinosinusitis with skull base and orbital erosion

2009 ◽  
Vol 124 (2) ◽  
pp. 161-165 ◽  
Author(s):  
M S Marfani ◽  
M A Jawaid ◽  
S M Shaikh ◽  
K Thaheem
Keyword(s):  
Skull Base ◽  
Sinus Surgery ◽  
Common Finding ◽  
Nasal Discharge ◽  
Topical Steroids ◽  
Fungal Sinusitis ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis ◽  
Postnasal Drip ◽  
Imaging Results

AbstractIntroduction:Allergic fungal rhinosinusitis is a benign, noninvasive sinus disease related to hypersensitivity to fungal infection having bony skull base and orbital erosion as common finding.Patients and method:This descriptive study was conducted at the department of otorhinolaryngology, Dow University of Health Sciences, Karachi, Pakistan, from April 2003 to March 2006. In forty-seven proven cases of allergic fungal sinusitis the following information was recorded: demographic data, signs and symptoms, laboratory investigation results, imaging results, pre- and post-operative medical treatment, surgery performed, follow up, and residual or recurrent disease. The Statistical Package for the Social Sciences version 10.0 software was used for data analysis.Results:Findings indicated that allergic fungal rhinosinusitis usually occurred in the second decade of life (51.06 per cent) in males (70.21 per cent), allergic rhinitis (100 per cent) and nasal polyposis (100 per cent). Nasal obstruction (100 per cent), nasal discharge (89.36 per cent), postnasal drip (89.36 per cent), and unilateral nasal and paranasal sinus involvement (59.57 per cent) were significant features. Aspergillus (59.57 per cent) was the most common aetiological agent. Combined orbital and skull base erosion was seen in 30.04 per cent of cases, with male preponderance 6.8:1. Endoscopic sinus surgery was performed in all cases, and recurrent or residual disease was observed in 19.14 per cent.Conclusion:Allergic fungal rhinosinusitis is a disease of young, immunocompetent individual. Skull base and orbital erosion are seen in one-third of cases. Bone erosion is 6.8 times more common in males than females. Orbital erosion is 1.5 times more common than skull base erosion. Endoscopic surgical debridement and drainage combined with topical steroids leads to resolution of disease in the majority of cases, without resorting to systemic antifungal agents, craniotomy or dural resection.

scholarly journals Study to Determine the Incidence of Allergic Fungal Sinusitis among Patients with Nasal Polyps and Its Related Risk Factors

2021 ◽  
Vol 15 (7) ◽  
pp. 1860-1863
Author(s):  
Bakht Zada ◽  
Ejaz Ahmed ◽  
Muhammad Habib ◽  
Zafar Iqbal ◽  
Rehan Saleem ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nasal Septum ◽  
Nasal Polyps ◽  
Bone Erosion ◽  
Histopathological Examination ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Deviated Nasal Septum ◽  
Allergic Fungal Sinusitis ◽  
Turbinate Hypertrophy

Aim: To govern the incidence of allergic fungal sinusitis in patients with nasal polyposis. Various anatomical risk factors were also investigated, including turbinate hypertrophy, deviated nasal septum and comorbidities such as asthma and diabetes. Study Design: This is a Descriptive cross-sectional study. Place and duration of study:The study was conducted at ENT Head &Neck Surgery department, Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for the duration of six months from May 2020 to October 2020. Methods: 110 patients with nasal polyps were evaluated and operated on. Samples were sent for histopathological examination and culture. All patients were assessed with clinical examination and detailed history. Laboratory tests were performed including complete blood counts, urea, electrolytes, ECG and chest radiographs for the suitability of general anesthesia as a prerequisite for surgery. In 95% of cases, computed tomography was recommended to check for sinus involvement, bone erosion, osteo-hypertrophic complex, turbinate hypertrophy, nasal septal deviation, and intracranial and intra-orbital enlargement. MRI examinations were also recommended in cases of suspected intraocular and intracranial disease (5%). Data was scrutinized on a computer using SPSS version 22.0. Results:Of the 110 patients, 65 were male and 45 were female, with a mean age of 1and ranged from 7 to 80 years. All patients had nasal polyps. The incidence of AFS was approximately 29.1% and the remaining 78 had a different pathology. Major deviation of the nasal septum and bilateral hypertrophy of the inferior turbinate’s were observed in 6 (18.7%) and 4 (12.5%) patients, respectively. Unilateral nasal polyps were observed in 7 (21.9%) patients and bilateral nasal polyps in 18 (52.3%). 19/32 (59.4%) of the cases underwent functional endoscopic surgery of the paranasal sinuses, and in 6 (18.7%) external fronto-ethmoidectomy. Two patients underwent nasal ethmoidectomy. Septoplasty and endoscopic sinus surgery were performed in a total of 3 (9.37%) cases. Key words:Allergic bronchopulmonary aspergillosis (ABPA), Allergic fungal sinusitis (AFS).

Allergic Fungal Sinusitis Associated with Allergic Bronchopulmonary Aspergillosis: An Uncommon Sinobronchial Allergic Mycosis

2007 ◽  
Vol 21 (4) ◽  
pp. 412-416 ◽  
Author(s):  
Jean Jacques Braun ◽  
Gabrielle Pauli ◽  
Philippe Schultz ◽  
André Gentine ◽  
David Ebbo ◽  
...  
Keyword(s):  
Allergic Bronchopulmonary Aspergillosis ◽  
Specific Ige ◽  
Antifungal Drugs ◽  
Sinus Surgery ◽  
Skin Tests ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Positive Skin ◽  
Oral Corticosteroids ◽  
Blood Eosinophils

Background The identification of allergic fungal sinusitis (AFS) is still controversial and much more recent than that of allergic bronchopulmonary aspergillosis (ABPA). Their association has been reported very rarely in the literature. Methods The aim of this study was to present a review of 6 cases of AFS associated with ABPA from a series of 12 cases of AFS and to compare AFS associated with ABPA and isolated AFS. Results All cases of AFS presented with chronic rhinosinusitis. The six cases with AFS and ABPA were atopic, asthmatic, with pulmonary infiltrates (five cases), central bronchiectasis (four cases), and both (three cases). The mycological and immunoallergological features of isolated AFS and AFS associated with ABPA were similar: eosinophilic allergic mucin with noninvasive fungi hyphae, high levels of blood eosinophils, total IgE, specific IgE, IgG, and positive skin tests to Aspergillus. The association of AFS and ABPA was concomitant (two cases) or remote in time (four cases). The treatment with oral corticosteroids and sinus surgery (six cases) associated with antifungal drugs (four cases) led to resolution in three cases, considerable improvement in one case, and therapeutic failure in two cases (follow-up longer than 5 years in all cases). Conclusion Independently of the signs linked to the organs involved (sinuses and bronchi) the mycological and immunoallergological features were similar for AFS and AFS associated with ABPA. AFS and ABPA can be isolated or associated in a sinobronchial allergic mycosis.

The Effect of the Total Intravenous Anesthesia Compared with Inhalational Anesthesia on the Surgical Field during Endoscopic Sinus Surgery

2005 ◽  
Vol 19 (5) ◽  
pp. 514-520 ◽  
Author(s):  
Peter J. Wormald ◽  
Graham van Renen ◽  
Jonathon Perks ◽  
Janine A. Jones ◽  
Claire D. Langton-Hewer
Keyword(s):  
Computed Tomography ◽  
Endoscopic Sinus Surgery ◽  
Controlled Trial ◽  
Total Intravenous Anesthesia ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Inhalational Anesthesia ◽  
Intravenous Anesthesia ◽  
Allergic Fungal Sinusitis ◽  
Surgical Field

Background Bleeding during endoscopic sinus surgery (ESS) may increase complications and negatively effect the surgery and its outcome. The aim of this study was to compare the surgical field in patients in whom total intravenous anesthesia (TIVA) is used as opposed to inhalation anesthesia. A prospective randomized controlled trial was performed. Methods Fifty-six patients undergoing ESS were randomly assigned to receive either inhaled sevoflurane with incremental doses offentanyl (n = 28) or TIVA via a propofol and remifentanil infusion (n = 28) for their general anesthesia. The surgical field was graded every 15 minutes using a validated scoring system. Results The two groups were matched for surgical procedure and computed tomography scores. Patients in the TIVA group were found to have a significantly lower surgical grade score than in the sevoflurane group (p < 0.001). Surgical grade score increased with time in both groups. Mean arterial pressure and pulse were found to influence the surgical field independently (p = 0.003 and p = 0.036 respectively). Mean surgical field grade scores were higher in the patients with allergic fungal sinusitis and nasal polyposis as opposed to chronic rhinosinusitis without polyps or fungus. Lund-Mackay computed tomography scores were found to correlate positively with surgical grade (Spearman rank correlation, p = 0.001). Conclusion In patients undergoing ESS, TIVA results in a better surgical field than inhalational anesthesia.

Current Indications for Pediatric Endoscopic Sinus Surgery

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P63-P63
Author(s):  
Rahul K Shah ◽  
George H Zalzal ◽  
Maria T Pena
Keyword(s):  
Cystic Fibrosis ◽  
Blood Clot ◽  
Tertiary Care ◽  
Care Facility ◽  
Acute Sinusitis ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Intracranial Complication ◽  
Tertiary Care Facility

Objective To describe current indications, sinonasal pathologies, and outcomes of endoscopic sinus surgeries (ESS) in children. Methods Retrospective chart review of children that underwent ESS at a children's tertiary care facility from July 2004 to June 2007 was performed. Demographic data, clinical profiles, surgical procedures including revisions, and complications were analyzed. Results 117 ESS were performed on 88 children (mean age 9.6 years) and 4 adults; 64 were male. The most common indications for ESS in descending order were: chronic rhino-sinusitis (CRS) (n=29), subperiosteal periorbital abscess (n= 20), sinonasal neoplasm (n= 11), intracranial complication from acute sinusitis (n=8), CRS with cystic fibrosis (n=8), complicated acute sinusitis (n=6), allergic fungal sinusitis (n=5), antrochonal polyps (n=2), invasive fungal sinusitis (n=1), and other pathologies (n=2). 21 children underwent an average of 2.2 sinus procedures. Majority of revisions were on patients with tumors (46%), allergic fungal sinusitis (40%), intracranial complication from acute sinusitis (38%), complicated acute sinusitis (33%), subperiosteal periorbital abscess (15%), CRS with cystic fibrosis (13%), and CRS (10%). Two children had excessive bleeding requiring another anesthetic to complete the procedure; 1 patient had airway obstruction from a tracheal blood clot requiring bronchoscopy. Conclusions More than 2/3rds of patients had ESS for indications other than uncomplicated CRS. Approximately 1/4 required revision surgeries reflecting the complexity of sinonasal pathologies seen in children compared with adults. Otolaryngologists performing pediatric ESS must not only be skilled in sound surgical technique, but must have appropriate interdisciplinary professional support to address the associated clinical problems seen in children.

Schizophyllum commune Sinusitis: A Case Report and Radiologic Findings

1995 ◽  
Vol 9 (3) ◽  
pp. 149-154 ◽  
Author(s):  
Brian E. Emery ◽  
Arnold D. Oberle ◽  
Fleurette Abreo ◽  
Terry A. Day ◽  
Fred J. Stucker
Keyword(s):  
Chronic Sinusitis ◽  
Schizophyllum Commune ◽  
Sinus Surgery ◽  
Fungal Sinusitis ◽  
Mri Findings ◽  
Allergic Fungal Sinusitis ◽  
Common Chronic Disease ◽  
Radiologic Findings ◽  
Magnetic Resonance Imaging Mri ◽  
First Time

Chronic sinusitis is now considered the most common chronic disease seen in this country.1 The infections are commonly polymicrobial and include aerobes and anaerobes.2 Fungal sinusitis accounts for up to 10% of cases of chronic sinusitis, and the disease ranges from allergic fungal sinusitis through fungus balls to invasive fungal sinus disease.3,4 We report the case of a 19-year-old black female with nasal obstruction, clear rhinorrhea, and nasal polyps. She underwent endoscopic sinus surgery after medical management failed to eradicate her symptoms. Cultures from her paranasal sinuses grew S. commune, a mushroom, a member of the Basidiomycetes. There have been four prior reports of S. commune sinusitis described in the literature. Presented is a review of the literature, a description of the histologic, mycologic, and radiologic findings and suggested treatment. The magnetic resonance imaging (MRI) findings are presented here for the first time.

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