DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20185304

Allergic fungal rhinosinusitis: a clinical study in Srikakulam

K. Jeevan Pradep, S. Ramesh, Hareesh .

Abstract


Background: Allergic fungal rhinosinusitis is one of the differential diagnoses for chronic bacterial rhinosinusitis. Recognition and understanding of this unique disease will lead to efficient diagnosis and treatment of this curable process. India being a tropical country, provides an apt environment for fungal growth, the clinical diagnosis of Allergic fungal rhinosinusitis should not be missed and should be thoroughly investigated and managed to prevent recurrence. The objective of the study was to verify the management protocol for allergic fungal rhinosinusitis, after surgical clearance with functional endoscopic sinus surgery and postoperative histopathological examination and to see the efficacy of steroid and antifungal treatment

Methods: A one year prospective study was considered with 28 patients from July 2016 to July 2017. Clinically suspected cases of rhinosinusitis depending upon their clinical presentation were subjected to nasal endoscopy, radiological examination and functional endoscopic sinus surgery. Postoperative histopathological examination was performed. Patients were followed up after giving steroid and antifungal treatment.  

Results: 28 cases were non-invasive. Aspergillus was found to be the most common isolate. The criteria responsible for good prognosis of allergic fungal rhinosinusitis management were mainly found to be functional endoscopic sinus surgery followed by topical corticosteroid therapy.

Conclusions: Allergic fungal rhinosinusitis is a disease entity on the rise. Prompt diagnosis and intervention prevents recurrence and complications.


Keywords


Rhinosinusitis, Nasal polyps, Hypersensitivity, Aspergillosis, Steroids, Itraconazole

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References


Chakrabarti A, Das A, Panda NK. Overview of fungal rhinosinusitis. Indian J Otolaryngol Head Neck Surg. 2004;56:251–8.

Mackenzie JJ. Preliminary report on aspergillus mycosis of the antrum maxillare. John Hopkins Hosp. Bull. 1893;4:9–10.

Oppe W. ZurKentnIss der schmalnelmykosenbelden Menschen. ZblAllg Path. 1987;8:301–6.

Hora JF. Primary aspergillosis of the paranasal sinuses and associated areas. Laryngoscope. 1965;75:768–73.

Saferstein B. Allergic bronchopulmonary aspergillosis with obstruction of the upper respiratory tract. Chest. 1976;70:788-90.

Miller JN, Johnston A, Lamb D. Allergic aspergillosis of the maxillary sinuses. Thorax. 1981;36:710.

Katzenstein AA, Sole SR, Greenberger PA. Allergic Aspergillus sinusitis:a newly recognized formof sinusitis. J Allergy ClinImmunol. 1983;72:82–93.

Manning SC, Schaefer SD, Close LG, Vuitch F. Culture positive allergic fungal sinusitis. Arch Otolaryngol. 1991;117:174–8.

Bent JP 3rd, Kuhn FA. Diagnosis of allergic fungal sinusitis. Otolaryngol Head Neck Surg. 1994;111(5):580-8.

McGill TJ, Simpson G, Healy GB. Fulminant aspergillosis of the nose and paranasal sinuses:a new clinical entity. Laryngoscope. 1980;90:748–54.

Ponikau JU, Sherris DA, Kern EB, et al. The diagnosis and incidence of allergic fungal sinusitis. Mayo Clin Proc. 1999;74:877–84.

Braun H, Buzina W, Freudenschuss K, Beham A, Stammberger H. Eosinophilic fungalrhinosinusitis: a common disorder in Europe? Laryngoscope. 2003;113:264–9.

Schubert MS, Hutcheson PS, Graff RJ, et al. HLA-DQB1*03 in allergic fungal sinusitis and other chronic hypertrophic rhinosinusitis disorders. J Allergy ClinImmunol. 2004;114:1376-83.

Lund VJ, Mackay IS. Staging in rhinosinusitis. Rhinology. 1993;107:183–4.

DeShazo RD, Swain RE, Diagnostic criteria for allergic fungal sinusitis. J Allergy ClinImmunol. 1995;96:24–35.

Schubert MS. Allergic fungal sinusitis. Otolaryngol Clin N Am. 2004;37:301–26.

Sohail MA, Al Khabori MJ, Hyder J, Verma A. Allergic fungal sinusitis:Can we predict the recurrence? Otolaryngol Head Neck Surg. 2004;131:704–10.

Thahim K, Jawaid MA, Marfani MS. Presentation and management of allergic fungal sinusitis. J Coll Physicians Surg Pak. 2007;17:23–7.

Ferguson BJ. What role do systemic corticosteroids, immunotherapy, and antifungal drugs play in the therapy of allergic fungal rhinosinusitis? Arch Otolaryngol Head Neck Surg. 1998;124:1174-8.