Allergic Fungal Rhinosinusitis Involving Frontal Sinus: A Prospective Study comparing Surgical Modalities

Abstract

Allergic fungal rhinosinusitis (AFRS) represents a hypersensitivity response to extramucosal fungi within the sinus cavity without evidence of tissue invasion. AFRS is characterized by fungal element with allergic mucin, Charcot-Leyden crystals, type I hypersensitivity, bony erosion with sinus infection on computed tomographic (CT) scan. Surgery remains the treatment of choice for AFRS followed by prolonged steroid therapy. Surgical approaches for frontal sinus disease can be either endonasal endoscopic or external. This is a nonrandomized prospective study, where the postoperative results of endoscopic frontal sinusotomy were compared with external frontoethmoidectomy approach. This is a nonrandomized prospective study, where the postoperative results of endoscopic frontal sinusotomy were compared with external frontoethmoidectomy approach. The comparison between external frontoethmoidectomy and endoscopic approach was done by using Chi-square test. There was no statistical significant difference found, when postoperatively clinical symptoms, radiology and investigations in patients of both the groups were compared. The success rate was 95.5% in group I and 91.1% after 6 months of follow-up. The world literature lacks prospective studies where attempts are made to compare the long-term results of both the surgical modalities for AFRS patients. Endoscopic endonasal approach has a distinct advantage over the external frontoethmoidectomy approach as it minimizes external scars over the face with almost equal or better long-term results.