Frequency of fungal infections in nasal polypi.

Objectives: Determine the frequency of fungal infections in nasal polypi. Study Design: Cross sectional study. Setting: Histopathology Department at Shaikh Zayed Hospital Lahore. Period: Six months from 12/2/2015 to 12/8/2015. Material & Methods: Two hundred surgical resections/biopsies using 95% confidence level, with 7% margin of error were collected. Formalin fixed specimens of patients of both genders and 10- 60 years of age with nasal polyps received after surgical procedure in department of ENT. Grossing and processing was done. Hematoxyin & Eosin stained sections were examined by two consultant Histopathologists independently. The presence of fungal hyphae was confirmed by PAS and Silver stains. The study was approved by College of Physicians & Surgeons Pakistan. All the data was entered and analyzed by using SPSS version 20. Results: Out of 200 patients all the patients showed the prescence of inflammatory cells in polyps (100%) with predominantly eosinophils in their submucosa (82%). Fungus was present in 48 cases (24%) most of them were in the age group of 42-57 years (13%) and 31(15.5%) patients having BMI <30 and 17(8.5%) having BMI >30 were positive for fungus.30 cases were of Aspergillus (62.5%) and rest 8 were of Mucor (37.5%). The fungus positive cases were more in males (13.5%). 160 of the cases were of unilateral polyps (80%) and 40 were of bilateral polypi (20%). Only 8% of the patients having diabetes had fungal infection. Conclusion: Hence, the frequency of fungal infection in nasal polypi is low with Aspergillus being the commonest pathogen affecting males predominantly.

Actinomycosis of maxillary antrum presenting as nasal polypi: a rare case

<p class="abstract">Actinomycosis is a rare anaerobic bacterial infection that presents in the form of cervicofacial, pulmonary, thoracic and abdominopelvic infections. It is usually caused by <em>Actinomyces israelii </em>which are a part of normal flora of aerodigestive tracts. They are opportunistic pathogens and cause infections which have odontogenic origin in oral cavity. Cervicofacial actinomycosis accounts for more than half of the cases and commonly affects the mandible. We are reporting a case of actinomycosis of left maxillary antrum presenting as a nasal polypi in a young man. He had presented with nasal discharge and yellowish crusts from left nasal cavity. Diagnostic nasal endoscopy revealed yellowish polypoidal mass arising from the left middle meatus. CT PNS showed soft tissue density mass measuring 3.7×4.3×4.1 cms in left maxillary antrum extending through and obliterating osteomeatal complex extending into left ethmoidal sinus. Patient underwent Functional endoscopic sinus surgery. The yellowish polypoidal mass in left nasal cavity was attached to the floor of the maxillary antrum by a thin stalk and had filled up the antrum. Histopathology of the specimen revealed inflammatory polyp with actinomycosis. Patient had an uneventful recovery and was put on long term antibiotics and regular follow up.</p>

Grafting to denuded nasal cavity for prevention of recurrent nasal polyposis by endoscopic sinus surgery

<p class="abstract"><strong>Background:</strong> The objective of the study was to avoid nasal polyposis occurrence after recurrent FEES.</p><p class="abstract"><strong>Methods:</strong> 87 patients undergoing recurrent FESS due to recurrent nasal polyposis, after completing all steps of FESS the placement of normal nasal mucosa from inferior turbinate or nasal septum instead of the mucosa of the fovea ethmoidalis and lamina papyracea was done. </p><p class="abstract"><strong>Results:</strong> There were nasal obstruction improvement in 79 patients (90.8%), but there were 8 patients (9.2%) had recurrent nasal polypi causing nasal obstruction. There was smell improvement in 38 patients (71.7%) out of 15 patients (28.3%).</p><p class="abstract"><strong>Conclusions:</strong> The nasal cavity grafting in FESS of recurrent nasal polyposis with nasal septal or inferior turbinate mucosa had promising results in prevention of nasal polyposis recurrence. These results made a recommendation of nasal cavity grafting during primary FESS of nasal polyposis.</p>