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).

Bilateral Antrochoanal Polyps: An Analysis from Four Cases

2016 ◽  
Vol 50 (4) ◽  
pp. 173-175
Author(s):  
Prachi Jain ◽  
Lokesh K Penubarthi ◽  
Eshaan Kaushik
Keyword(s):  
Nasal Septum ◽  
Close Association ◽  
Inferior Turbinate ◽  
Sinus Surgery ◽  
Easy Access ◽  
Rare Entity ◽  
Deviated Nasal Septum ◽  
Turbinate Hypertrophy ◽  
Inferior Turbinate Hypertrophy

ABSTRACT Bilateral antrochoanal polyps (ACPs) are a rare entity. We studied four cases of bilateral ACPs that presented to us. We found a close association of allergy (75%) and chronic rhinosinusitis (CRS) (50%) as etiological factors. The anatomical factors like deviated nasal septum (75%), inferior turbinate hypertrophy (50%), and concha bullosa (25%) are also commonly associated with bilateral ACPs. Endoscopic sinus surgery was performed in all the patients with special emphasis to correct the anatomical factors. Inferior meatal antrostomy was performed in two cases to allow easy access of the angled microdebrider blade for clearing the polyp from the anterolateral and anterosuperior limits of the antrum. After a mean follow-up period of 23 months, no recurrence was found. How to cite this article Virk RS, Penubarthi LK, Gupta AK, Jain P, Kaushik E. Bilateral Antrochoanal Polyps: An Analysis from Four Cases. J Postgrad Med Edu Res 2016;50(4):173-175.

scholarly journals A PROSPECTIVE STUDY ON ASSOCIATION BETWEEN DEVIATED NASAL SEPTUM AND SINUSITIS AT ENT DEPARTMENT OF SKMCH, MUZAFFARPUR, BIHAR

2020 ◽  
pp. 21-22
Author(s):  
Kameshwar Prasad Singh ◽  
Debarshi Jana
Keyword(s):  
Nasal Septum ◽  
Chronic Sinusitis ◽  
Anatomical Variation ◽  
Middle Turbinate ◽  
Sinus Surgery ◽  
Nasal Discharge ◽  
World Population ◽  
Deviated Nasal Septum ◽  
Turbinate Hypertrophy ◽  
Group I

Background: Chronic sinusitis (CS) is an extremely prevalent disorder. It affects up to two percent of the world population. It has a significant impact on the quality of life of people. Basically, the word “sinusitis‟ refers to a group of disorders characterized by inflammation of mucosa of nose and paranasal sinuses. Deviated Nasal septum is one of the most common disorder that presents up to 62% of the population. Its role in the pathogenesis of chronic sinusitis remains uncertain. Methods: Two groups were included in this study.Each group had 30 cases with Midline nasal septum & Deviated nasal septum. This study conducted in the Department. of ENT, Sri Krishna Medical College and Hospital, Muzaffarpur, Bihar. The duration of the study was over a period of six months from August 2019 to January 2020. Results: We were studied two groups, 30 cases involved in group I of Midline nasal septum and in group II 30 cases involved with Deviated nasal septum. In this study we showed symptom & sign of rhinoscopy. In the group I, 14 cases had congested nasal mucosa followed by 10 cases of nasal discharge, 4 cases of inferior turbinate hypertrophy & 2 cases of Middle turbinate hypertrophy. Conclusions: that management of chronic maxillary sinusitis should include simultaneous treatment of any anatomical variation. For treating chronic sinusitis along with deviated nasal septum, nowadays treatment of choice is Septoplasty along with Functional Endoscopic Sinus Surgery (FESS). FESS technique is used for managing sinus infection and ostial obstruction.

scholarly journals Effects of Age on Recovery of Olfactory Function After Endoscopic Sinus Surgery and Related Risk Factors

2021 ◽  
pp. 014556132110129
Author(s):  
Weiping Qi ◽  
Liang Feng ◽  
Fengyan Yang ◽  
Weihuan Ma
Keyword(s):  
Risk Factors ◽  
Allergic Rhinitis ◽  
Endoscopic Sinus Surgery ◽  
Nasal Polyps ◽  
Protective Factor ◽  
Olfactory Function ◽  
Sinus Surgery ◽  
The Poor ◽  
Related Risk ◽  
Good Improvement

Objectives: To study the effects of age on the olfactory function recovery of chronic rhinosinusitis patients after endoscopic sinus surgery and related risk factors. Methods: A total of 176 chronic rhinosinusitis (CRS) patients enrolled from February 2017 to October 2019 were divided into child, youth, middle-aged, and elderly groups. Their baseline data, T&T olfactory test score, visual analogue scale (VAS) olfactory score, sinus computed tomography (CT) Lund-Mackay score, and Lund-Kennedy score were compared. Based on postoperative olfactory function, they were divided into good and poor improvement groups. Results: Complication with nasal polyps, allergic rhinitis history, and sinus surgery history had significant differences among patients of different ages ( P < .05). Three months after surgery, T&T olfactory, VAS olfactory, Lund-Mackay, and Lund-Kennedy scores all rose with increasing age, with significant differences between any 2 groups ( P < .05). The improvement of postoperative olfactory function became poorer with aging ( P < .05). T&T and VAS olfactory scores had significant positive correlations with Lund-Mackay and Lund-Kennedy scores ( P < .001). Age, preoperative Lund-Mackay and Lund-Kennedy scores, complication with nasal polyps, allergic rhinitis history, sinus surgery history, and postoperative complications were risk factors for the poor improvement of postoperative olfactory function. Doctor-directed treatment was a protective factor for good improvement. Conclusions: The improvement of olfactory function of CRS patients after endoscopic sinus surgery declines with aging. Age, preoperative Lund-Mackay and Lund-Kennedy scores, complication with nasal polyps, allergic rhinitis history, sinus surgery history, and postoperative complications are risk factors for the poor improvement of postoperative olfactory function. Doctor-directed treatment is a protective factor for good improvement.

Ethnic and Gender Differences in Bone Erosion in Allergic Fungal Sinusitis

2004 ◽  
Vol 18 (6) ◽  
pp. 397-404 ◽  
Author(s):  
Sarah K. Wise ◽  
Giridhar Venkatraman ◽  
Justin C. Wise ◽  
John M. DelGaudio
Keyword(s):  
Gender Differences ◽  
Bone Erosion ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
And Gender

scholarly journals CLINICAL PROFILE OF CHRONIC RHINOSINUSITIS: A STUDY IN CENTRAL INDIA

2021 ◽  
pp. 104-106
Author(s):  
Tanvi Rekhade ◽  
A.Z. Nitnaware ◽  
Seema Patel ◽  
R.T. Pawar ◽  
Ashish Keche
Keyword(s):  
Quality Of Life ◽  
Chronic Rhinosinusitis ◽  
Nasal Septum ◽  
Nasal Polyps ◽  
Central India ◽  
Nasal Discharge ◽  
Deviated Nasal Septum ◽  
Northern India ◽  
Causative Factors

Chronic Rhinosinusitis (CRS) has heavy implications on the quality of life and has a prevalence of about 46.1 % in northern India with similar pattern across the country.This research has been undertaken to study the presentation and causative factors for CRS in central India. Data of 100 patients diagnosed as CRS was studied. Patients presented with nasal obstruction and nasal discharge at large. Nasal polyps were seen in 37% cases. The most common associated etiopathological factor was anatomical obstruction due to deviated nasal septum.

Diagnosis of Allergic Fungal Sinusitis

1994 ◽  
Vol 111 (5) ◽  
pp. 580-588 ◽  
Author(s):  
John P. Bent ◽  
Frederick A. Kuhn
Keyword(s):  
Nasal Polyposis ◽  
Bone Erosion ◽  
Skin Tests ◽  
Type I ◽  
Fungal Culture ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
High Attenuation ◽  
Fungal Invasion ◽  
History Of

Allergic fungal sinusitis is a noninvasive disease first recognized approximately one decade ago. It accounts for approximately 6% to 8% of all chronic sinusitis requiring surgical intervention and has become a subject of increasing interest to otolaryngologists and related specialists. Although certain signs and symptoms, as well as radiographic, intraoperative, and pathologic findings, may cause the physician to suspect allergic fungal sinusitis, no standards have been defined for establishing the diagnosis. It is extremely important to recognize allergic fungal sinusitis and differentiate it from chronic bacterial sinusitis and other forms of fungal sinusitis because the treatments and prognoses for these disorders vary significantly. To delineate a set of diagnostic criteria, we prospectively evaluated our most recent 15 patients with allergic fungal sinusitis. An allergy evaluation confirmed atopy through a strong history of inhalant mold allergies, an elevated total immunoglobulin E level, or a positive result of a skin test or radioallergosorbent test to fungal antigens in 100% of patients. All 15 patients had nasal polyposis, and 8 of 15 had asthma. There was a unilateral predominance in 13 of 15 cases. A characteristic computerized tomography finding of serpiginous areas of high attenuation in affected sinuses was seen in all patients, and 12 of 15 patients had some degree of radiographic bone erosion. Pathologic examination uniformly revealed eosinophilic mucus without fungal invasion into soft tissue; Charcot-Leyden crystals and peripheral eosinophilic were each observed in 6 of 15 patients. Every patient had fungus identified on fungal smear, although only 11 of 15 fungal cultures were positive. Therefore, for the diagnosis of allergic fungal sinusitis to be established, the following criteria should be met: (1) type I hypersensitivity confirmed by history, skin tests, or serology; (2) nasal polyposis; (3) characteristic computed tomography signs; (4) eosinophilic mucus without fungal invasion into sinus tissue; and (5) positive fungal stain of sinus contents removed during surgery. Radiographic bone erosion does not necessarily imply invasive disease, and a positive fungal culture, although desirable, is not necessary to confirm the diagnosis. Unilateral predominance of disease, a history of asthma, Charcot-Leyden crystals, and peripheral eosinophilla corroborate the diagnosis but are not always present. Perhaps because of the novelty of the disease, much misunderstanding surrounds allergic fungal sinusitis. Misdiagnosis is common, recurrence rates are high, and proper treatment remains elusive. Before proceeding with other advances, a common understanding of the diagnosis of allergic fungal sinusitis is mandatory.

scholarly journals The Efficiency of Routine Histopathological Examination for Bilateral Nasal Polyposis

2019 ◽  
pp. 014556131987272
Author(s):  
Ahmad Safadi ◽  
Narin N. Carmel-Neiderman ◽  
Ronen Toledano ◽  
Omer J. Ungar ◽  
Fadi Abu Mokh ◽  
...  
Keyword(s):  
Nasal Polyps ◽  
Histopathological Examination ◽  
Medical Center ◽  
The Elderly ◽  
Inverted Papilloma ◽  
Sinus Surgery ◽  
Low Incidence ◽  
Other Neoplasms ◽  
Histopathological Result ◽  
Endoscopic Nasal Surgery

The necessity to routinely carry out histopathologic examinations of surgically removed polyps in patients with chronic rhinosinusitis with bilateral nasal polyps (CRSwNP) is uncertain. The aim of this study was to describe the histopathology of polyps from a large series of patients who underwent endoscopic sinus surgery for CRSwNP and the rate of neoplasms. This is a retrospective study of the histopathological result of all patients with CRSwNP who underwent functional endoscopic nasal surgery and in whom histologic examination was performed, from 2006 to 2015, in a tertiary medical center. Data on demographics and whether a nasal lesion was suspected for neoplasm prior to surgery were analyzed. Two hundred thirty-five patients underwent bilateral nasal polypectomy and histopathologic examinations of the surgical specimens. The rate of neoplasms in nonsuspicious cases was 2.3% (5 cases) and all were inverted papilloma. To conclude, inverted papilloma and other neoplasms are considered rare incidental findings in patients presenting with bilateral nasal polyps. This study demonstrated a higher rate of the latter than that reported in the literature. Our study further emphasizes that despite the low incidence of these pathologies, a histopathologic examination of every nasal polypectomy is warranted so as not to miss potential serious pathologies. We stress that a routine histopathological examination should be practiced at least in the elderly population.

scholarly journals Computed tomographic evaluation of inflammatory sinonasal diseases

2017 ◽  
Vol 5 (2) ◽  
pp. 537
Author(s):  
Rashmi Kandukuri ◽  
Suresh Phatak
Keyword(s):  
Sensitivity And Specificity ◽  
Histopathological Examination ◽  
Anatomical Variations ◽  
Final Diagnosis ◽  
Sinus Surgery ◽  
P Value ◽  
Fungal Culture ◽  
Fungal Sinusitis ◽  
Ct Diagnosis ◽  
Diagnostic Modality

Background: Computed Tomography plays a major diagnostic role in patients with inflammatory sinonasal diseases and determines the mode of management by displaying the complex osteomeatal anatomy, determining anatomical variations, extent of disease and characterizing various inflammatory sinonasal diseases. Purpose of the study was to assess the role of CT in evaluation of inflammatory sinonasal diseases by evaluating the sensitivity and specificity of CT in diagnosis of various inflammatory Sinonasal diseases.Methods: In this hospital based prospective study 122 patients with symptomatic inflammatory sinonasal diseases were evaluated by 16 slice MDCT. CT diagnosis is correlated with final diagnosis obtained from findings of nasal endoscopy/Functional Endoscopic Sinus Surgery, histopathological examination and fungal culture. Statistical analysis was done by descriptive and inferential statistics using Test statistics (sensitivity, specificity, PPV, NPV and accuracy) and Z test for single proportions (Z value >1.96 is considered significant). Software used in the analysis was SPSS 17.0 version and graph pad prism 6.0 version and p <0.05 is considered as level of significance.Results: On correlating CT diagnosis with final diagnosis, Chronic Sinusitis had 98.41% sensitivity and 96.61% specificity, fungal sinusitis had 66.67% sensitivity and specificity 99.14%, polyps had sensitivity of 94.59% and specificity of 97.6%, the rest of the inflammatory conditions had sensitivity 93.7 % and 99% specificity. P value in all instances was <0.05, i.e. <0.0001, indicating the significance of the findings.Conclusions: CT is the diagnostic modality of choice in evaluation of various inflammatory pathologies and associated complications thereby planning the further management of the patient.

scholarly journals Olfactory Disorder is the Specific Symptom to Distinguish Eosinophilic from non-eosinophilic Nasal Polyps

2020 ◽  
Author(s):  
Xiaodan Pan ◽  
Yuan Zhang ◽  
Chengshuo Wang ◽  
Luo Zhang
Keyword(s):  
Risk Factors ◽  
Nasal Polyps ◽  
Disease Duration ◽  
Clinical Symptoms ◽  
Nasal Congestion ◽  
Sinus Surgery ◽  
Specific Symptom ◽  
Logistic Analysis ◽  
Significant Difference ◽  
Olfactory Disorder

Abstract Background: Patients with eosinophilic chronic rhinosinusitis with nasal polyps (eCRSwNP) have poorer outcomes after endoscopic sinus surgery and a higher recurrence rate. This study aimed to investigate the profile of clinical symptoms of eCRSwNP and the related risk factors.Methods: We prospectively enrolled 298 CRSwNP inpatients from February 2019 to December 2019. Patients were divided into eCRSwNP and non-eCRSwNP groups based on the percentage of blood eosinophils. Clinical data on questionnaires, visual analogue scale (VAS) scores, and laboratory tests were collected. The differences in clinical symptoms, including nasal congestion, rhinorrhea, olfactory disorders, and head/facial pain, between the two groups were analyzed to identify the influential factors. Logistic analysis and receiver operating characteristic curves were used to determine the diagnostic benefit for the specific symptom in eCRSwNP patients.Results: Of the four major clinical symptoms, nasal congestion and olfactory disorders were significantly different between eCRSwNP and non-eCRSwNP groups. Patients with eCRSwNP more frequently complained about olfactory disorders (P = 0.002), while patients with non-eCRSwNP mostly had nasal congestion (P = 0.001). The logistic analysis showed that the primary risk factors for olfactory disorders of eCRSwNP were disease duration (P = 0.014) and alcohol intake (P = 0.012). Olfactory disorders were not associated with the disease course of eCRSwNP but were correlated with the disease duration of non-eCRSwNP (P = 0.008). When the clinical duration was less than 10 years, there was a significant difference in olfactory disorders between eCRSwNP and non-eCRSwNP groups (P < 0.01). However, when the clinical duration was over 10 years, the difference was not statistically significant (P = 0.264). The VAS score of olfactory disorders of over 5.75 could be used to predict the diagnosis of eCRSwNP (area under the curve ＝0.674, 95% confidence intervals: 0.559–0.689, P = 0.000). Conclusions: Olfactory disorder was the major nasal symptom that could be used to distinguish eCRSwNP and non-eCRSwNP. ECRSwNP patients were more prone to have olfactory dysfunction. Our findings suggested that evaluation of nasal symptoms would help diagnose eCRSwNP and determine subsequent clinical treatment strategies.

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