Objectives: To evaluate the role of partial middle turbinectomy (PMT) in patients with allergic fungal sinusitis (AFS) managed by endoscopic sinus surgery (ESS) in the prevention of recurrence and adequate management of residual disease. Patients and Methods: This prospective study, conducted on 60 patients, suffering from AFS diagnosed clinically and radiologically after presenting to the Otolaryngology clinic at faculty of medicine Cairo University and Misr University for Science and Technology during the period of March 2021 to August 2022. Patients were randomly divided into 2 equal groups. All Patients underwent ESS. The middle turbinate was preserved in Group A patients while PMT was performed in group B patients. Both the groups were compared postoperatively in the outpatient clinic in a period of up to 9 months in the outpatient clinic to detect recurrence of allergic fungal sinusitis, patency of sinuses was assessed endoscopically. Results:In the current study we found that recurrence was less frequent in PMT group at 6 months follow up 0.0% (n=0) (Group B turbinectomy Group) compared to recurrence 20.0% (n=6) in (Group A preserved Group) the differences started to be statistically significant after the 6 months assessment point. And was still significantly lower at 13.3% (n=4) compared to 36.7% (n=11) after 9 months. Also, there were no significant incidences of bleeding or orbital injury in either group. Conclusion:This study demonstrated that PMT decreased the chances of recurrence of disease.

Objective: This case-control study aimed to detect the presence of fungal biofilms in cases of fungal sinusitis, trying to find its role in recurrence of fungal sinus infection and resistance to medical treatment. Patients and Methods: This study was conducted at Ain-Shams University from June-2017 to June-2018 upon 20 patients as the fungal cases are not much in Egypt. All patients were subjected to functional endoscopic sinus surgery and taking specimens. Examination of specimens by scanning electron microscope was made. Results: The prevalence of fungal biofilms was 7 (70%) in cases and 0 (0%) in controls (p-value = 0.001). There is higher risk of fungal biofilms in cases of fungal sinusitis, the odds of biofilms is higher in the study group 2.33 than in the control group 0. The lower is the invasiveness, the higher is the fungal biofilms (OR = 0.94, 95% CI 0.46 -4.05). Also, the analysis showed that the lower is the recurrence the lower is the fungal biofilms (OR = 2.25, 95% CI 0.15 -7.93). Conclusion: This study showed the presence of fungal biofilms in different cases of fungal sinusitis whether primary or recurrent, also whether invasive or non-invasive. Studies with large sample size are recommended to get a strong evidence.

Background The first case of fungal sinusitis was reported in 1885. This fungal disease occurred rarely until the past decade, when a worldwide increase in its incidence occurred. Till one decade back bacteria was implicated as pathogen in most form of chronic rhinosinusitis (CRS). Fungi were thought to be responsible for few specific forms, sine 1999, when ponikau and associates claimed that fungi were responsible for nearly all cases of CRS. Their study demonstrated the presence of fungi & eosinophils from nose & paranasal sinuses from ∼96 % cases of CRS. Aim of the Work The aim of the work was to detect the presence of fungal biofilm, in patients with fungal sinusitis trying to find its role in recurrence of fungal sinus infection, resistance to medical treatment and occurrence of intra orbital and intracranial complications. Patients and Methods The study consisted of 20 different cases of fungal sinusitis controlled by 10 cases of non fungal sinusitis. Control cases were divided into 5 cases of chronic sinusitis with nasal polyposis and 5 cases of deviated septum with no evidence of sinusitis undergoing nasal surgery. Results Using statistical analysis, there was evidence of pressure of fungal biofilm in different cases of fungal sinusitis whether primary or recurrent, also whether invasive or non invasive. Comparing cases with controls, There was statistically significant difference between them as regard Biofilm (p-value: < 0.001) with incidence reaching (70 %) in cases while (0%) in controls. By applying risk analysis for biofilm, we used relative risk (p value = 0.0001) which is statistically significant indicating higher risk of positive biofilm in cases of fungal sinusitis, also by Using odds ratio (p value= 0.0002) which is statistically significant indicating higher risk of positive biofilm in cases of fungal sinusitis. Conclusion The study showed the presence of fungal biofilm in different cases of fungal siunsitis whether primary or recurrent, also whether invasive or non invasive.