Allergic Fungal Rhinosinusitis in Saudi Arabia: A Review of Recent Literature

Alahmari, Abdussalam

doi:10.7759/cureus.20683

Cited by 5 publications

(5 citation statements)

References 80 publications

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“…Sinus computed tomography shows findings of chronic rhinosinusitis that often include central areas of increased contrast (hyperattenuation) that represent the presence of fungal containing allergic mucin [17] .…”

Section: Discussionmentioning

confidence: 99%

Effect of Partial Middle Turbinectomy on the Recurrence of Allergic Fungal Sinusitis: A Comparative Study

Lashin

Falah

Fattah

et al. 2023

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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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.

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Section: Discussionmentioning

confidence: 99%

Effect of Partial Middle Turbinectomy on the Recurrence of Allergic Fungal Sinusitis: A Comparative Study

Lashin

Falah

Fattah

et al. 2023

Egyptian Journal of Ear, Nose, Throat and Allied Sciences

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“…[9][10][11] The reported MRI findings of AFS included low signal intensity on T1-weighted images (T1WI) and a signal void on T2-weighted imaging (T2WI) MRI (due to dense fungal concretions and heavy metals). [6,12,13] Because of its widespread availability, quick scan duration, and capacity to examine many organs simultaneously, CT scans are the most often utilized imaging modality for initial AFS diagnosis. However, few investigations have focused on the MRI findings of the AFS.…”

Section: Introductionmentioning

confidence: 99%

Value of MRI signal intensity in evaluation of allergic fungal rhinosinusitis compared with CT Hounsfield units: Retrospective study

Alsalem,

Almontashri,

Alsalem

et al. 2024

Medicine

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“Allergic fungal sinusitis (AFS)” is typically diagnosed using radiologic images like computed tomography (CT) scans and magnetic resonance imaging (MRI), with the “Hounsfield unit (HU)” in CT scans and T2-weighted images (T2WI) in MRI serving as reliable objective parameters. However, diagnosing AFS might be difficult because of possible signal changes and densities caused by variations in the secretion concentration in the sinus. Few studies have compared the diagnostic performance of MRI and CT scans. This study aimed to investigate the value of MRI signal intensity in evaluating AFS compared with CT HUs. This retrospective study included 111 patients with pathologically confirmed AFS who underwent CT imaging followed by MRI evaluation at King Saud Medical City, Riyadh, Saudi Arabia, from January 2012 to December 2022. Radiographic densities of sinus opacities on CT scan, including the mean HU values, and MRI findings, including signal voids on T1-weighted images and T2WI, were gathered and analyzed. To determine the efficacy of these radiographic characteristics in predicting the disease and the best cutoff value, we employed receiver operator characteristic curves. The mean age was 31.9 ± 15.6 years, and most patients were 74 females (66.7%). The main symptom was nasal obstruction in 73 patients (65.8%). In comparison, between HU and signal void on T2WI, there was moderate predictive performance [area under the curve: 0.856, P = .001]. An ideal HU cutoff value of 69.50 HU was obtained with a sensitivity of 100% and a specificity of 44.7%. However, the receiver operator characteristic for T1-weighted images could not be plotted, as no signal was avoided to predict AFS and it was not statistically significant (area under the curve: 0.566; P = .287). The study found a CT HU of 69.5 can predict MRI T2WI signal values with a void signal, aiding in diagnostic workup and evaluation for AFS.

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“…The process is extradural via bony erosion, inducing damage by compression but not invasion, leading to proptosis, diplopia, visual disturbances, and hypertelorism. 17 Treatment of AFRS also comes with its own set of challenges. While most patients with AFRS have favorable outcomes without the use of antifungal medications if corticosteroids and surgical debridement of the affected sinuses are promptly initiated, [18][19][20][21] there are cases where these measures may not be sufficient.…”

Section: Introductionmentioning

confidence: 99%

“…The process is extradural via bony erosion, inducing damage by compression but not invasion, leading to proptosis, diplopia, visual disturbances, and hypertelorism. 17…”

Section: Introductionmentioning

confidence: 99%

Acute Vision Loss in Patients With Allergic Fungal Rhinosinusitis: A Case Series

Allami,

Alarfaj,

Almousa

et al. 2023

Therapeutic Advances in Allergy and Rhinology

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Allergic fungal rhinosinusitis (AFRS) is a subtype of chronic noninvasive sinusitis accounting for 7.8% (0.2%-26.7%) of all chronic rhinosinusitis cases. A definitive diagnosis is usually made after sinus surgery. Successful treatment requires a combination of surgical and medical management. Although orbital involvement is relatively common, reports on optic neuropathy and acute vision loss are limited. Herein, we present a series of 3 patients with AFRS who presented with acute visual loss as the chief complaint. All 3 patients were otherwise healthy adults in their early 20s with extensive nasal polyps on endoscopic nasal examination and bone erosion in the bilateral orbits and lateral wall of the sphenoid sinus on the affected side on imaging. One of the 3 patients had bilateral cranial nerve IV defects in addition to cranial nerve III defects. All patients underwent endoscopic sinus surgery with orbital decompression and were followed up postoperatively by both otolaryngology and ophthalmology services with endoscopic and radiologic evaluation. Unfortunately, no meaningful improvement in vision was observed in any patient despite successful nerve decompression. Prompt diagnosis and early medical and surgical intervention are warranted to prevent complications in patients with AFRS with orbital extension.

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Allergic Fungal Rhinosinusitis in Saudi Arabia: A Review of Recent Literature

Cited by 5 publications

References 80 publications

Effect of Partial Middle Turbinectomy on the Recurrence of Allergic Fungal Sinusitis: A Comparative Study

Effect of Partial Middle Turbinectomy on the Recurrence of Allergic Fungal Sinusitis: A Comparative Study

Value of MRI signal intensity in evaluation of allergic fungal rhinosinusitis compared with CT Hounsfield units: Retrospective study

Acute Vision Loss in Patients With Allergic Fungal Rhinosinusitis: A Case Series

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