Allergic Fungal Sinusitis: Can We Predict the Recurrence?

Sohail, M.A.; Khabori, Mazin Jawad Al; Hyder, Jamil; Verma, Ashok

doi:10.1016/j.otohns.2004.04.004

Cited by 15 publications

(10 citation statements)

References 18 publications

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“…Unilateral presentation was high in our study similar to studies by Bent & Kuhn 15 Sohail et al 16 and Thahim et al 10 Intra op findings were extensive nasal polyposis with thick mucin which was of pea nut butter appearance were present. The debrided tissue was sent for HPE which showed fungal hyphae, eosinophils, charcot laden crystals in all cases.…”

Section: Discussionsupporting

confidence: 90%

Ocular manifestations and treatment outcome of allergic fungal pan sinusitis

Sharanabasamma¹,

Vaibhav

2022

IJOOO

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To know the incidence and treatment outcome of various ocular manifestations of allergic fungal pan sinusitis. A prospective study was conducted in a medical college hospital in south India for a period of 2 years which included all the cases of allergic fungal pansinusitis presented to the hospital. The cases were diagnosed by Bent-Kuhn criteria. The cases with ophthalmologic involvement were included in the study. CT scan of PNS, brain, orbit were done and the disease extent was noted. Cases with eye involvement were planned for surgical debridement after an initial prednisolone oral 1mg/kg over 2 weeks. Surgical debridement was done endoscopically by a team of ENT surgeon, oculoplastic surgeon and neurosurgeon. Histopathologic examination was done. Post-surgery the steroids were tapered over 2 weeks. Post operative follow up was done every day for first week followed by weekly once till a month and every 6 monthly once for a year in the form of clinical examination, CT scan was repeated after a week during post op period. In cases with suspected recurrence CT PNS was performed. Their outcomes were analyzed. 6 cases (33%) had ocular involvement. Proptosis was the most common (28%) finding followed by epiphora (22.2%), ophthalmoparesis (22.2%), diplopia (22.2%), ophthalmoplegia (11.%), complete loss of vision (5%). Surgical intervention led to early recovery in proptosis followed by others except with PL -ve case. Early treatment in AFPS prevents vision loss and has better outcomes.

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Section: Discussionsupporting

confidence: 90%

Ocular manifestations and treatment outcome of allergic fungal pan sinusitis

Sharanabasamma¹,

Vaibhav

2022

IJOOO

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“…In a study of 44 patients with AFS [26], CT scans showed involvement of three or more sinuses in all patients. Both unilateral [35, 38] and bilateral [8, 34, 39] predominance of the disease was noticed in different series. Mukherji et al [36] retrospectively reviewed CT scans, along with surgical and histologic reports, in 45 patients with AFS and found an almost equal preponderence of unilateral (49%) and bilateral involvement (51%).…”

Section: Introductionmentioning

confidence: 99%

Allergic Aspergillus sinusitis and its association with allergic bronchopulmonary aspergillosis

Panjabi

Shah

2011

Asia Pacific Allergy

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Allergic Aspergillus sinusitis (AAS) is a three decade old clinicopathologic entity in which mucoid impaction akin to that of allergic bronchopulmonary aspergillosis (ABPA) occurs in the paranasal sinuses. Features such as radiographic evidence of pansinusitis, passage of nasal plugs and recurrent nasal polyposis in patients with an atopic background is suggestive of AAS. Histopathlogic confirmation from the inspissated mucus is a sine qua non for the diagnosis. Heterogeneous densities on computed tomography of the paranasal sinuses are caused by the 'allergic mucin' in the sinuses. Many patients give a history of having undergone multiple surgical procedures for symptomatic relief. The current approach to treatment appears to include an initial surgical debridement followed by postoperative oral corticosteroids for long durations. Although both ABPA and AAS are classified as Aspergillus-related hypersensitivity respiratory disorders, their co-occurrence appears to be an infrequently recognised phenomenon. This could perhaps be attributed to the fact that these two diseases are often treated by two different specialties. A high index of suspicion is required to establish the diagnoses of ABPA and AAS. All patients with asthma and/or rhinosinusitis along with sensitisation to Aspergillus antigens are at an increased risk of developing ABPA and/or AAS. ABPA must be excluded in all patients with AAS and vice versa. Early diagnosis and initiation of appropriate therapy could plausibly alter the course of the disease processes and prevent the possible development of long term sequelae.

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“…Our recurrence rate of 20% is lower than the average rate in current literature. 19 The 2 patients in this series that required reoperation were allergic to all 6 of the common fungal allergens, and 1 of these patients was started on SLIT prior to surgery. As noted previously, Ferguson 18 has recognized initiation of immunotherapy prior to surgery as a risk factor for treatment failure.…”

Section: Discussionmentioning

confidence: 92%

Sublingual Immunotherapy for Allergic Fungal Sinusitis

Melzer

Driskill

Clenney

et al. 2015

Ann Otol Rhinol Laryngol

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Allergic fungal sinusitis (AFS) is a condition that has an allergic basis caused by exposure to fungi in the sinonasal tract leading to chronic inflammation. Despite standard treatment modalities, which typically include surgery and medical management of allergies, patients still have a high rate of recurrence. Subcutaneous immunotherapy (SCIT) has been used as adjuvant treatment for AFS. Evidence exists to support the use of sublingual immunotherapy (SLIT) as a safe and efficacious method of treating allergies, but no studies have assessed the utility of SLIT in the management of allergic fungal sinusitis. A record review of cases of AFS that are currently or previously treated with sublingual immunotherapy from 2007 to 2011 was performed. Parameters of interest included serum IgE levels, changes in symptoms, Lund-McKay scores, decreased sensitization to fungal allergens associated with AFS, and serum IgE levels. Ten patients with diagnosed AFS were treated with SLIT. No adverse effects related to the use of SLIT therapy were identified. Decreases in subjective complaints, exam findings, Lund-McKay scores, and serum IgE levels were observed. Thus, sublingual immunotherapy appears to be a safe adjunct to the management of AFS that may improve patient outcomes.

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Allergic Fungal Sinusitis: Can We Predict the Recurrence?

Cited by 15 publications

References 18 publications

Ocular manifestations and treatment outcome of allergic fungal pan sinusitis

Ocular manifestations and treatment outcome of allergic fungal pan sinusitis

Allergic Aspergillus sinusitis and its association with allergic bronchopulmonary aspergillosis

Sublingual Immunotherapy for Allergic Fungal Sinusitis

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